PROFILUL METABOLIC AL PACIENTULUI CU LITIAZÃ BILIARÃ COLESTEROLICÃ
Metabolic syndrome is a clustering of cardiovascular risk factors as well as
associated co morbidities, including cholesterol gallstones disease.The aim of our study is to
prove the association between metabolic syndrome and cholesterol gallstones, to identify the
main risk factors for this association and to trace the particularities of the metabolic syndrome
in such patients. Material and method: Our cohort study enrolled 449 subjects, 312 patients
diagnosed with metabolic syndrome and gallstones or cholecystectomy (group 1) and 137
patients diagnosed only with metabolic syndrome (group 2), hospitalized in the Respiratory
Rehabilitation Medical Clinic between 2007-2009. Results: 85.25% of the patients with
metabolic syndrome and cholesterol gallstones and 79.92% of the patients with metabolic
syndrome alone had a body mass index (BMI) ³ 25 Kg/m2. Univariate and multivariate logistic
regression were used to calculate the risk of gallstone disease associated with different
metabolic syndrome variables. Waist circumference, BMI, fasting glycemia, insulinemia and
insulin resistance index (HOMA-IR) registered statistical significant differences between the
two study groups and were significantly associated with a higher risk of cholesterol gallstone as
well as were blood pressure values ³130/85 mmHg. The presence of 4 or 5 components of the
metabolic syndrome increased the risk of gallstone disease by 3 times (OR = 3.3, p<0.001)
compared to a 2 times higher risk (OR=2.1, p=0.02) in case of increased insulin resistance;
there was no statistical significance for any of the lipid parameters. Conclusion: In our study,
cholesterol gallstones appeared strongly associated with anthropometric measurements, fasting
glycemia and insulin resistance index, as well as with the presence of metabolic syndrome as
defined by the new clinical definition, despite the negative results for the lipidic components.
These findings are consistent with the hypothesis that insulin resistance plays an important role
in the pathogenesis and that cholesterol gallstone disease belong to metabolic syndrome.
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