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Significant Association Between Gallstone Disease and Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis

Digestive Diseases and Sciences volume 61, pages 2389–2396 (2016)Cite this article

Abstract

Background

Gallstone disease (GD) and nonalcoholic fatty liver disease (NAFLD) are common digestive disorders worldwide. Both conditions share certain risk factors including obesity, insulin resistance and diabetes. Several epidemiologic studies have reported the relationship between these two conditions.

Aim

We conducted a systematic review and meta-analysis to characterize the association between GD and NAFLD.

Methods

A comprehensive search of the databases MEDLINE and EMBASE was performed from inception through November 2015. The inclusion criterion was the observational studies’ assessment of the association between GD and NAFLD in adult participants. Pooled odds ratio (OR) and 95 % confidence interval (CI) were calculated using a random-effects model.

Results

Data were extracted from 12 observational studies (9 cross-sectional studies, 1 case–control study and 2 cohort studies). The pooled OR of NAFLD in patients who had GD was 1.55 (95 % CI 1.31–1.82). The statistical between-studies heterogeneity (I 2) was 64 %. The association remained significant when limited to cohort studies with pooled OR 1.33 (95 % CI 1.14–1.55, I 2 = 0 %).

Conclusion

Our meta-analysis demonstrated that GD is significantly associated with NAFLD. Further prospective studies exploring the underlying mechanism of this association should be pursued.

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Acknowledgments

We thank Matthew Roslund for validation of the search.

Author contributions

VJ conceived of the study, assessed the quality of the studies and drafted the manuscript. SU searched the literature, assessed the quality of the studies, performed the statistical analysis and drafted the manuscript. AS participated in the statistical analysis and drafted the manuscript. All authors read and approved the final manuscript.

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Authors and Affiliations

  1. Department of Internal Medicine, University of Hawaii, Honolulu, HI, USA

    Veeravich Jaruvongvanich

  2. Department of Medicine, King Chulalongkorn Memorial Hospital, Bangkok, Thailand

    Veeravich Jaruvongvanich

  3. Department of Internal Medicine, Bassett Medical Center and Columbia University College of Physicians and Surgeons, Cooperstown, NY, 13326, USA

    Anawin Sanguankeo & Sikarin Upala

  4. Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

    Anawin Sanguankeo & Sikarin Upala

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  1. Veeravich Jaruvongvanich
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Correspondence to Sikarin Upala.

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Jaruvongvanich, V., Sanguankeo, A. & Upala, S. Significant Association Between Gallstone Disease and Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis. Dig Dis Sci 61, 2389–2396 (2016). https://doi.org/10.1007/s10620-016-4125-2

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  • DOI: https://doi.org/10.1007/s10620-016-4125-2

Keywords

  • Nonalcoholic fatty liver disease
  • Gallstones
  • Cholelithiasis
  • Meta-analysis
  • Insulin resistance