Prevalence of biopsy-proven nonalcoholic fatty liver among patients with gallstone disease
Faisal A Alsaif1, Sara H Alqahtani1, Amani M Alsadoon2, Khalid A Alswat2, Ayman A Abdo2, Mazen M Hassanain1, Abdulsalam B Alsharabi1, Ghadeer R Aljuhani3, Hisham M Alkhalidi4, Mohammad S Elsharkawy5, Maram A Alotaibi4, Faisal M Sanai6, Waleed K Al-hamoudi7
1 Department of Surgery, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
2 Liver Disease Research Center, King Saud University, Riyadh, Kingdom of Saudi Arabia
3 Department of Surgery, King Salman Hospital, Riyadh, Kingdom of Saudi Arabia
4 Department of Pathology, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
5 Department of Radiology and Medical Imaging, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
6 Department of Medicine, Gastroenterology Unit, King Abdulaziz Medical City, Jeddah, Kingdom of Saudi Arabia
7 Liver Disease Research Center, King Saud University; Department of Liver Transplant, King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia
Dr. Faisal A Alsaif
Department of Surgery, College of Medicine, King Saud University, PO Box 2925, Riyadh - 11461
Kingdom of Saudi Arabia
Source of Support: None, Conflict of Interest: None
Background/Aim: Gallstone disease (GD) and nonalcoholic fatty liver disease (NAFLD) are associated with metabolic syndrome. Despite the benign nature of NAFLD, 10% of patients may develop advanced fibrosis and cirrhosis. We aimed to identify the prevalence and factors associated with NAFLD among GD patients in the Saudi population.
Patients and Methods: This is a single-center, observational cohort study that included patients seen in general surgery clinics at our institution from 2011 to 2017. All liver biopsies were taken at the same time as the cholecystectomy. Demographical and clinical data were prospectively collected from the study population.
Results: Of the 301 GD patients in the study, 15% had a normal body mass index (BMI), 29% were overweight, and 56% were obese. There were 143 (47.8%) patients with NAFLD, of which 125 (41.8%) showed steatosis and 18 (6%) had nonalcoholic steatohepatitis. There was a significant positive correlation between NAFLD and age (r = 0.243; P < 0.0001), and BMI (r = 0.242; P < 0.0001). Obese patients with BMI 30–40 kg/m were 2.403 (P = 0.039) more likely to have NAFLD compared with normal BMI patients, and this value increased to 6.145 (P = 0.002) in patients with BMI >40 kg/m. Additionally, patients with T2DM were 2.839 times (P = 0.015) more likely to have NAFLD compared with those who did not.
Conclusions: The prevalence of NAFLD among GD patients is high. High BMI and diabetes are independent factors associated with NAFLD in GD patients. The results suggest that there may be a need for routine liver biopsy in selected patients during cholecystectomy.