The Korean journal of internal medicine

The Korean Association of Internal Medicine (대한내과학회)
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Insulin Resistance as a Risk Factor for Gallbladder Stone Formation in Korean Postmenopausal Women

  • Kim, Sang-Soo (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Lee, Jeong-Gyu (Department of Family Medicine, Pusan National University School of Medicine) ;
  • Kim, Dong-Wok (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Kim, Bo-Hyun (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Jeon, Yun-Kyung (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Kim, Mi-Ra (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Huh, Jeong-Eun (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Mok, Ji-Young (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Kim, Seong-Jang (Department of Medical Research Insititute, Pusan National University School of Medicine) ;
  • Kim, Yong-Ki (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Kim, In-Joo (Department of Internal Medicine, Pusan National University School of Medicine)
  • Published : 2011.09.01
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Abstract

Background/Aims: The objective of this study was to determine whether insulin resistance is associated with gallbladder stone formation in Korean women based on menopausal status. Methods: The study included 4,125 consecutive Korean subjects (30-79 years of age). Subjects who had a medical history of diabetes, hypertension, dyslipidemia, other cardiovascular disorders, or hormone replacement therapy were excluded. The women were subdivided into two groups according to their menopausal status. Results: Analysis of premenopausal women showed no significant differences in the homeostasis model of assessment-insulin resistance (HOMA-IR) index between the two groups in terms of gallstone disease. The associations between the occurrence of gallbladder stones and age, obesity, abdominal obesity, hyperinsulinemia, and high HOMA-IR index were statistically significant in the analysis with postmenopausal women. In a multiple logistic regression analysis, low high density lipoprotein-cholesterol was an independent predictor of gallbladder stone formation in premenopausal women. However, the multiple logistic regression analysis also showed that age and HOMA-IR were significantly associated with gallbladder stone formation in postmenopausal women. In an additional analysis stratified by obesity, insulin resistance was a significant risk factor for gallbladder stone formation only in the abdominally obese premenopausal group. Conclusions: Insulin resistance may be associated with gallbladder stone formation in Korean postmenopausal women with abdominal obesity.

Keywords

References

  1. Everhart JE, Khare M, Hill M, Maurer KR. Prevalence and ethnic differences in gallbladder disease in the United States. Gastroenterology 1999;117:632-639. https://doi.org/10.1016/S0016-5085(99)70456-7
  2. Shaffer EA. Gallstone disease: epidemiology of gallbladder stone disease. Best Pract Res Clin Gastroenterol 2006;20:981-996. https://doi.org/10.1016/j.bpg.2006.05.004
  3. Nervi F, Miquel JF, Alvarez M, et al. Gallbladder disease is associated with insulin resistance in a high risk Hispanic population. J Hepatol 2006;45:299-305. https://doi.org/10.1016/j.jhep.2006.01.026
  4. Mendez-Sanchez N, Chavez-Tapia NC, Motola-Kuba D, et al. Metabolic syndrome as a risk factor for gallstone disease. World J Gastroenterol 2005;11:1653-1657. https://doi.org/10.3748/wjg.v11.i11.1653
  5. George ED, Schluger LK. Special women's health issues in hepatobiliary diseases. Clin Fam Pract 2000;2:155-169. https://doi.org/10.1016/S1522-5720(05)70011-8
  6. Kim Sw, Park YH, Choi JW. Clinical and epidemiological analysis of 10-year experienced 1,719 gallstone patients. Korean J Gastroenterol 1993;25:159-167.
  7. Kim MH, Lim BC, Myung SJ, et al. Epidemiological study on Korean gallstone disease: a nationwide cooperative study. Dig Dis Sci 1999;44:1674-1683. https://doi.org/10.1023/A:1026643817349
  8. Park YH, Park SJ, Jang JY, et al. Changing patterns of gallstone disease in Korea. World J Surg 2004;28:206-210. https://doi.org/10.1007/s00268-003-6879-x
  9. Yang SH, Lee SE, Jang JY, et al. Clinical and epidemiological analysis of gallstone patients focused on 25-year experience of surgically treated patients. Korean J Gastroenterol 2007;50:42-50.
  10. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985;28:412-419. https://doi.org/10.1007/BF00280883
  11. Filly RA, Allen B, Minton MJ, Bernhoft R, Way LW. In vitro investigation of the origin of echoes with biliary sludge. J Clin Ultrasound 1980;8:193-200. https://doi.org/10.1002/jcu.1870080302
  12. Carol AM. General ultrasound. Edinburgh: Churchill Livingstone, 1992.
  13. Alberti KG, Zimmet P, Shaw J. Metabolic syndrome--a new world-wide definition: A Consensus Statement from the International Diabetes Federation. Diabet Med 2006;23:469-480. https://doi.org/10.1111/j.1464-5491.2006.01858.x
  14. Lee SY, Park HS, Kim DJ, et al. Appropriate waist circumference cutoff points for central obesity in Korean adults. Diabetes Res Clin Pract 2007;75:72-80. https://doi.org/10.1016/j.diabres.2006.04.013
  15. Diehl AK. Cholelithiasis and the insulin resistance syndrome. Hepatology 2000;31:528-530. https://doi.org/10.1002/hep.510310238
  16. Ruhl CE, Everhart JE. Association of diabetes, serum insulin, and C-peptide with gallbladder disease. Hepatology 2000;31:299-303. https://doi.org/10.1002/hep.510310206
  17. Nepokroeff CM, Lakshmanan MR, Ness GC, Dugan RE, Porter JW. Regulation of the diurnal rhythm of rat liver beta-hydroxy-beta-methylglutaryl coenzmye A reductase activity by insulin, glucagon, cyclic AMP and hydrocortisone. Arch Biochem Biophys 1974;160:387-396. https://doi.org/10.1016/0003-9861(74)90412-3
  18. Storer GB, Topping DL, Trimble RP. Direct stimulation by glucose and insulin of glycogen synthesis in perfused rat liver. FEBS Lett 1981;136:135-137. https://doi.org/10.1016/0014-5793(81)81231-8
  19. Scragg RK, Calvert GD, Oliver JR. Plasma lipids and insulin in gall stone disease: a case-control study. Br Med J (Clin Res Ed) 1984;289:521-525. https://doi.org/10.1136/bmj.289.6444.521
  20. Haffner SM, Diehl AK, Mitchell BD, Stern MP, Hazuda HP. Increased prevalence of clinical gallbladder disease in subjects with non-insulin-dependent diabetes mellitus. Am J Epidemiol 1990;132:327-335. https://doi.org/10.1093/oxfordjournals.aje.a115662
  21. Chang Y, Sung E, Ryu S, Park YW, Jang YM, Park M. Insulin resistance is associated with gallstones even in non-obese, nondiabetic Korean men. J Korean Med Sci 2008;23:644-650. https://doi.org/10.3346/jkms.2008.23.4.644
  22. Maclure KM, Hayes KC, Colditz GA, Stampfer MJ, Speizer FE, Willett WC. Weight, diet, and the risk of symptomatic gallstones in middle-aged women. N Engl J Med 1989;321:563-569. https://doi.org/10.1056/NEJM198908313210902
  23. Tsai CJ, Leitzmann MF, Willett WC, Giovannucci EL. Central adiposity, regional fat distribution, and the risk of cholecystectomy in women. Gut 2006;55:708-714. https://doi.org/10.1136/gut.2005.076133
  24. Uhler ML, Marks JW, Voigt BJ, Judd HL. Comparison of the impact of transdermal versus oral estrogens on biliary markers of gallstone formation in postmenopausal women. J Clin Endocrinol Metab 1998;83:410-414. https://doi.org/10.1210/jc.83.2.410
  25. Thijs C, Knipschild P. Oral contraceptives and the risk of gallbladder disease: a meta-analysis. Am J Public Health 1993;83:1113-1120. https://doi.org/10.2105/AJPH.83.8.1113
  26. Hulley S, Grady D, Bush T, et al. Randomized trial of estrogen plus progestin for secondary prevention of coronary heart disease in postmenopausal women: Heart and Estrogen/progestin Replacement Study (HERS) Research Group. JAMA 1998;280:605-613. https://doi.org/10.1001/jama.280.7.605
  27. Cirillo DJ, Wallace RB, Rodabough RJ, et al. Effect of estrogen therapy on gallbladder disease. JAMA 2005;293:330-339. https://doi.org/10.1001/jama.293.3.330
  28. Thijs C, Knipschild P, Brombacher P. Serum lipids and gallstones: a case-control study. Gastroenterology 1990;99:843-849. https://doi.org/10.1016/0016-5085(90)90978-A
  29. Petitti DB, Friedman GD, Klatsky AL. Association of a history of gallbladder disease with a reduced concentration of highdensity- lipoprotein cholesterol. N Engl J Med 1981;304:1396-1398. https://doi.org/10.1056/NEJM198106043042305
  30. Valdivieso V, Covarrubias C, Siegel F, Cruz F. Pregnancy and cholelithiasis: pathogenesis and natural course of gallstones diagnosed in early puerperium. Hepatology 1993;17:1-4.
  31. Maringhini A, Ciambra M, Baccelliere P, et al. Biliary sludge and gallstones in pregnancy: incidence, risk factors, and natural history. Ann Intern Med 1993;119:116-120. https://doi.org/10.7326/0003-4819-119-2-199307150-00004

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