Case Control Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 28, 2020; 26(44): 6979-6992
Published online Nov 28, 2020. doi: 10.3748/wjg.v26.i44.6979
Fatty liver is an independent risk factor for gallbladder polyps
Dong-Won Ahn, Ji Bong Jeong, Jinwoo Kang, Su Hwan Kim, Ji Won Kim, Byeong Gwan Kim, Kook Lae Lee, Sohee Oh, Soon Ho Yoon, Sang Joon Park, Doo Hee Lee
Dong-Won Ahn, Ji Bong Jeong, Jinwoo Kang, Su Hwan Kim, Ji Won Kim, Byeong Gwan Kim, Kook Lae Lee, Department of Internal Medicine, Seoul National University College of Medicine, Seoul 03080, South Korea
Dong-Won Ahn, Ji Bong Jeong, Jinwoo Kang, Su Hwan Kim, Ji Won Kim, Byeong Gwan Kim, Kook Lae Lee, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul 07061, South Korea
Sohee Oh, Department of Biostatistics, Medical Research Collaborating Center, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul 07061, South Korea
Soon Ho Yoon, Sang Joon Park, Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul 03080, South Korea
Doo Hee Lee, Department of Research and Development, MEDICALIP Co. Ltd., Seoul 03127, South Korea
Author contributions: Ahn DW planned and design the study, performed acquisition, analysis, and interpretation of data, drafted the manuscript, made critical revisions related to important intellectual content, and approved the manuscript; Jeong JB planned and design the study, performed acquisition, analysis, and interpretation of data, made critical revisions related to important intellectual content, and approved the manuscript; Kang J and Kim SH performed acquisition, analysis, and interpretation of data; Oh S, Kim JW, Kim BG and Lee KL performed analysis and interpretation of data, made critical revisions related to important intellectual content, and approved the manuscript; Yoon SH performed imaging analysis, reviewed imaging of computed tomography, and finally confirmed the results of the review; Park SJ and Lee DH performed imaging analysis and reviewed imaging of computed tomography.
Institutional review board statement: The study was approved by the Institutional Review Board of Seoul National University Boramae Medical Center (IRB No. 30-2020-054).
Informed consent statement: The subjects in this study were not required to give informed consent due to retrospective nature of the study and utilization of anonymous data utilization.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Ji Bong Jeong, MD, PhD, Associate Professor, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, 20 Borame-ro 5-gil, Dongjak-gu, Seoul 07061, South Korea. jibjeong@snu.ac.kr
Received: August 11, 2020
Peer-review started: August 11, 2020
First decision: October 18, 2020
Revised: October 28, 2020
Accepted: November 13, 2020
Article in press: November 13, 2020
Published online: November 28, 2020
Abstract
BACKGROUND

Gallbladder polyps (GBPs) are known to be associated with obesity and metabolic diseases. However, to date, the relationship between GBPs and abnormal body fat distribution, such as fatty liver, visceral obesity, or sarcopenia, has not yet been established.

AIM

To evaluate whether GBPs are associated with fatty liver, visceral obesity, or sarcopenia.

METHODS

We retrospectively reviewed the medical records of subjects who underwent various laboratory tests, body composition measurement with a non-invasive body composition analyzer, and abdominal ultrasonography during health checkups. A total of 1405 subjects with GBPs were compared with 2810 age- and sex-matched controls.

RESULTS

The mean age of the subjects was 46.8 ± 11.7 years, and 63.8% were male. According to multiple logistic regression analysis, the presence of fatty liver [odds ratio (OR) 1.413; 95% confidence interval (CI) 1.218-1.638; P < 0.001] was an independent risk factor for GBP, together with low levels of alanine aminotransferase (OR 0.993; 95%CI 0.989-0.996; P < 0.001). Additionally, fatty liver showed both independent (OR 1.629; 95%CI, 1.335-1.988; P < 0.001) and dose-dependent (moderate to severe fatty liver; OR 2.137; 95%CI, 1.662-2.749; P < 0.001) relationship with large GBPs (≥ 5 mm). The presence of sarcopenia and high visceral fat area were not significantly associated with GBPs.

CONCLUSION

Fatty liver was found to be closely associated with GBPs irrespective of sarcopenia and visceral obesity.

Keywords: Gallbladder polyp, Fatty liver, Sarcopenia, Visceral obesity, Risk factors, Body fat distribution

Core Tip: This is a retrospective cross-sectional study evaluating relationship between gallbladder polyp (GBP) and various body compositions including body fat distribution by using data from routine health checkups. According to this study, only fatty liver was an independent risk factor for GBP among the body compositions; visceral obesity and sarcopenia were not associated with GBP. There was a dose-dependent relationship between GBP and fatty liver especially in the larger GBP group. The results of this study suggest that careful assessment of GBP using abdominal ultrasonography be considered in patients with severe fatty liver.