The relationship between gallstones and gall bladder polyps and metabolic syndrome

Aim: Metabolic syndrome is a complex risk factor that increases the risk of cardiovascular disease, including signs and symptoms of abdominal obesity, high triglycerides, low high-density lipoprotein (HDL) cholesterol, high glucose and hypertension. In addition to affecting quality of life, gallstones are a chronic disease that causes cholecystitis, pancreatitis, biliary obstruction, and the risk of developing gall bladder cancer and significant economic expense. Gall bladder polyps are a risk factor for the development of gall bladder cancer, which increases the diagnosis rate by increasing the hepatobiliary ultrasound imaging frequency. As a result of economic developments and industrialization in our country, there has been an increase in the traditional eating habits change and sedantery life. With these changes, the prevalence of obesity and metabolic syndrome has increased. Correction of the metabolic syndrome parameters may lead to a decrease in the prevalence of gallstones and gall bladder polyps which cause significant economic expense and increase the risk of developing gall bladder cancer. For this reason, we aimed to investigate the relationship between gallstones and gall bladder polyps and metabolic syndrome. Material and method: Between September 2016 and January 2017, the study included those who applied to Ankara Yildirim Beyazit University Medical Faculty Atatürk EAH Internal Medicine, Gastroenterology and General Surgery clinics. The study consisted of 139 participants, 60 of which were gallstones (20 male, 40 female), 16 gall bladder polyps (6 male, 10 female) and 63 control group (27 male, 36 female). Participants' height, weight, waist circumference, body mass index (BMI), blood pressure were measured. Venous blood glucose, triglyceride (TG), high-density lipoprotein (HDL) cholesterol, and Hbs Ag were analyzed after at least 8 hours of fasting. Patients with cholecystectomy, pancreatitis, major GIS operation history, bile duct wall thickening, chronic kidney disease, pregnant women, Hbs Ag status unknown, alcohol, oral contraceptive use and those who did not want to participate in the study were not included in the study. Metabolic syndrome was defined according to the metabolic syndrome diagnostic criteria published in the 2006 International Diabetes Federation (IDF) guideline. We carried out a cross-sectional study. Results: As a total of one hundred and thirty-nine individuals were included in our study 53 (%38.1) were male and 86 (%61.9) were female. The mean age of participants was 46.98 ± 13.19 years. The age and gender distribution of the groups were similar (p> 0.05). When the groups were compared in terms of initial measurements of SBP and DBP, SBP levels of patients with gallstones were lower than those of the control group (p <0.05); it was seen that DBP levels were lower in gallstone group than both control group and gall bladder polyp patients. When the patients were assessed according to IDF criteria, 44.4% (n = 28) of the control group; 40% of patients with gallstones (n = 24); 43.8% (n = 7) of the gall bladder polyp patients were found to have metabolic syndrome. There was no difference in the groups according to the presence of metabolic syndrome (χ2 = 0.261, p = 0.878). 33.9% (n = 20) of the patients with metabolic syndrome were male and 66.1% were female. The incidence of metabolic syndrome was higher in patients over 50 years of age (χ2 = 6.042; p = 0.014). In the group with high BMI, the incidence of metabolic syndrome was found to be higher (χ2 = 14.936, p <0.001). It was observed that 91.9% of the women (n = 79) and 67.9% of the men (n = 36) met the waist circumference criteria and the proportion of women who met the waist circumference criteria was higher than that of the males (χ2 = 11.529; p = 0.001). Conclusion: According to the results of our study, there was no relation between gallstones and gall bladder polyps and metabolic syndrome. Metabolic syndrome was seen more in women. The incidence of metabolic syndrome was found to increase with age and BMI.