gallstone disease is associated with more severe liver damage in patients with non-alcoholic fatty liver disease胆石病与更严重的肝损伤患者非酒精脂肪肝.pdfVIP

Gallstone Disease Is Associated with More Severe Liver Damage in Patients with Non-Alcoholic Fatty Liver Disease 1 1 2 3 1 Anna Ludovica Fracanzani , Luca Valenti , Maurizio Russello , Luca Miele , Cristina Bertelli , 2 1 3 3 4 Alessandro Bellia , Chiara Masetti , Consuelo Cefalo , Antonio Grieco , Giulio Marchesini , Silvia Fargion1* 1 Department of Internal Medicine, Centro Studi Malattie Metaboliche del Fegato, University of Milano, Maggiore Policlinico Hospital, IRCCS Ca’ Granda Foundation, Milano, Italy, 2 Liver Unit, ARNAS, Garibaldi Hospital, Catania, Italy, 3 Department of Internal Medicine, Cattolica University, Roma, Italy, 4 Department of Internal Medicine, Alma Mater Studiorum University, Bologna, Italy Abstract Background: Nonalcoholic fatty liver disease (NAFLD) and gallstone disease (GD) are both highly prevalent in the general population and associated with obesity and insulin resistance. We aimed to evaluate the prevalence of GD in a cross sectional study of NAFLD patients and to define whether the presence of GD is associated with diabetes and predicts more severe liver disease. Methodology/Principal Findings: We merged databases of four Liver Units, comprising 524 consecutive biopsy-proven NAFLD (373 males) observed between January 2003 and June 2010. GD was diagnosed in 108 (20%), and 313 cases (60%) were classified by liver biopsy as nonalcoholic steatohepatitis (NASH). The GD subgroup was characterized by a significantly higher prevalence of females, prediabetes/diabetes, abdominal obesity and metabolic syndrome, older age, higher BMI,