Insulin resistance and incident gallbladder disease in pregnancy

被引：30

作者：

Ko, C. W.

Beresford, S. A. A.

Schulte, S. J.

Lee, S. P.

机构：

[1] Department of Medicine, University of Washington, Seattle, WA

[2] Department of Epidemiology, University of Washington, Seattle, WA

[3] Department of Radiology, University of Washington, Seattle, WA

来源：

CLINICAL GASTROENTEROLOGY AND HEPATOLOGY | 2008年 / 6卷 / 01期

关键词：

D O I：

10.1016/j.cgh.2007.10.007

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background & Aims: Insulin resistance is associated with prevalent gallstones, but its effect on initial gallstone formation is not well-understood. Methods: We conducted a nested case-control study to examine whether insulin resistance is a risk factor for initial gallbladder sludge and stone formation during pregnancy. Cases were 205 women with new gallbladder sludge and stones during pregnancy and the early postpartum. Controls were 443 randomly selected women without sludge or stones during pregnancy. Gallbladder ultrasounds were obtained during each trimester and at 4-6 weeks post partum. Fasting serum glucose, lipids, and insulin were measured at 26-28 weeks gestation. Insulin resistance was measured by the homeostasis model. Logistic regression was used to identify independent risk factors for gallstone formation. Results: Insulin resistance was significantly greater in cases than in controls on univariate analysis (P < .001). Pre-pregnancy body mass index was strongly associated with gallstone formation on univariate analysis (P < .001), but this association was diminished after adjusting for insulin resistance (P = .01). On multivariate analysis, insulin resistance was significantly associated with gallstone formation (P = .004), even after adjustment for pre-pregnancy body mass index and other confounding factors including high-density lipoprotein cholesterol and physical activity. This association was strongest in women with pre-pregnancy body mass index <30 kg/m2. Conclusions: Insulin resistance is a risk factor for incident gallbladder sludge and stones during pregnancy, even after adjustment for body mass index. Insulin resistance might represent a causal link between obesity and overweight and gallstones. © 2008 AGA Institute.

引用

页码：76 / 81

页数：6

共 34 条

[1]

The burden of gastrointestinal diseases, (2001)

[2]

Ruhl C.E., Everhart J.E., Association of diabetes, serum insulin, and C-peptide with gallbladder disease, Hepatology, 31, pp. 299-303, (2000)

[3]

Ruhl C.E., Everhart J.E., Relationship of serum leptin concentration and other measures of adiposity with gallbladder disease, Hepatology, 34, pp. 877-883, (2001)

[4]

Everhart J.E., Khare M., Hill M., Et al., Prevalence and ethnic differences in gallbladder disease in the United States, Gastroenterology, 117, pp. 632-639, (1999)

[5]

Barbara L., Sama C., Morselli-Labate A.M., Et al., A population study on the prevalence of gallstone disease: the Sirmione study, Hepatology, 7, pp. 913-919, (1987)

[6]

The epidemiology of gallstone disease in Rome, Italy. Part II: factors associated with the disease, Hepatology, 8, pp. 907-913, (1988)

[7]

Maringhini A., Ciambra M., Baccelliere P., Et al., Biliary sludge and gallstones in pregnancy: incidence, risk factors, and natural history, Ann Intern Med, 119, pp. 116-120, (1993)

[8]

Maringhini A., Marceno M.P., Lanzarone F., Et al., Sludge and stones after pregnancy, J Hepatol, 5, pp. 218-223, (1987)

[9]

Valdivieso V., Covarrubias C., Siegel F., Et al., Pregnancy and cholelithiasis: pathogenesis and natural course of gallstones diagnosed in early puerperium, Hepatology, 17, pp. 1-4, (1993)

[10]

Ko C.W., Beresford S.A., Schulte S.J., Et al., Incidence, natural history, and risk factors for biliary sludge and stones during pregnancy, Hepatology, 41, pp. 359-365, (2005)

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