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Steatocholecystitis and Fatty Gallbladder Disease

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Abstract

Obesity has become an epidemic worldwide. It is accompanied by a multitude of medical complications including metabolic syndrome. Obesity may lead to fatty infiltration of multiple internal organs including liver, heart, kidney, and pancreas, causing organ dysfunctions. Fatty infiltration leads to chronic inflammation and tissue damage. Fatty infiltration in the liver results in nonalcoholic fatty liver disease, which is increasingly common nowadays. Recent studies in animals and humans indicate that obesity also is associated with fatty infiltration of gallbladder, resulting in cholecystosteatosis. The increased gallbladder lipids include free fatty acids, phospholipids, and triglycerides. Enhanced inflammation with an increased amount of fat in the gallbladder results in an abnormal wall structure and decreased contractility. In support of this notion, a recent experiment on the effect of Ezetimibe, which is a novel drug that inhibits intestinal fat absorption, on fatty gallbladder disease reveals that Ezetimibe can ameliorate cholecystosteatosis and restore in vivo gallbladder contractility. The proportion of cholecystectomies performed for chronic acalculous cholecystitis has increased significantly over the past two decades. An increase in gallbladder fat, which leads to poor gallbladder emptying and biliary symptoms, may partly explain this phenomenon. Although dietary carbohydrates have been demonstrated to be associated with fatty gallbladder disease, other potential modifiable environmental factors are not clear. The pathogenesis and prognosis of fatty gallbladder disease, including steatocholecystitis, and the relations of fatty gallbladder disease to nonalcoholic fatty liver disease, including steatohepatitis, and other components of metabolic syndrome are largely unknown. More research is needed to answer these questions.

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References

  1. Ogden CL, Yanovski SZ, Carroll MD, et al. The epidemiology of obesity. Gastroenterology. 2007;132(6):2087–2102. doi:10.1053/j.gastro.2007.03.052.

    Article  PubMed  Google Scholar 

  2. Mokdad AH, Ford ES, Bowman BA, et al. Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. JAMA. 2003;289(1):76–79. doi:10.1001/jama.289.1.76.

    Article  PubMed  Google Scholar 

  3. Li C, Ford ES, McGuire LC, et al. Increasing trends in waist circumference and abdominal obesity among US adults. Obesity (Silver Spring). 2007;15(1):216–224. doi:10.1038/oby.2007.505.

    Article  Google Scholar 

  4. Ford ES, Giles WH, Mokdad AH. Increasing prevalence of the metabolic syndrome among US Adults. Diabetes Care. 2004;27(10):2444–2449. doi:10.2337/diacare.27.10.2444.

    Article  PubMed  Google Scholar 

  5. Bergman RN, Kim SP, Hsu IR, Catalano KJ, et al. Abdominal obesity: role in the pathophysiology of metabolic disease and cardiovascular risk. Am J Med. 2007;120(suppl 1(2)):S3–S8. doi:10.1016/j.amjmed.2006.11.012.

    Article  PubMed  CAS  Google Scholar 

  6. Lann D, LeRoith D. Insulin resistance as the underlying cause for the metabolic syndrome. Med Clin North Am. 2007;91(6):1063–1077. doi:10.1016/j.mcna.2007.06.012. viii.

    Article  PubMed  CAS  Google Scholar 

  7. de Luca C, Olefsky JM. Inflammation and insulin resistance. FEBS Lett. 2008;582(1):97–105. doi:10.1016/j.febslet.2007.11.057.

    Article  PubMed  Google Scholar 

  8. Bastard JP, Maachi M, Lagathu C, et al. Recent advances in the relationship between obesity, inflammation, and insulin resistance. Eur Cytokine Netw. 2006;17(1):4–12.

    PubMed  CAS  Google Scholar 

  9. Ruhl CE, Everhart JE. Association of diabetes, serum insulin, and C-peptide with gallbladder disease. Hepatology. 2000;31(2):299–303. doi:10.1002/hep.510310206.

    Article  PubMed  CAS  Google Scholar 

  10. Nervi F, Miquel JF, Alvarez M, et al. Gallbladder disease is associated with insulin resistance in a high risk Hispanic population. J Hepatol. 2006;45(2):299–305. doi:10.1016/j.jhep.2006.01.026.

    Article  PubMed  CAS  Google Scholar 

  11. Szczepaniak LS, Victor RG, Orci L, et al. Forgotten but not gone: the rediscovery of fatty heart, the most common unrecognized disease in America. Circ Res. 2007;101(8):759–767. doi:10.1161/CIRCRESAHA.107.160457.

    Article  PubMed  CAS  Google Scholar 

  12. Pitt HA. Hepato-pancreato-biliary fat: the good, the bad and the ugly. HPB (Oxford). 2007;9(2):92–97. doi:10.1080/13651820701286177.

    Google Scholar 

  13. Antuna-Puente B, Feve B, Fellahi S, et al. Adipokines: the missing link between insulin resistance and obesity. Diabetes Metab. 2008;34(1):2–11.

    PubMed  CAS  Google Scholar 

  14. Angulo P. Obesity and nonalcoholic fatty liver disease. Nutr Rev. 2007;65(6 Pt 2):S57–S63. doi:10.1301/nr.2007.jun.S57-S63.

    Article  PubMed  Google Scholar 

  15. Clark JM. The epidemiology of nonalcoholic fatty liver disease in adults. J Clin Gastroenterol. 2006;40(suppl 1):S5–S10.

    PubMed  Google Scholar 

  16. Edmison J, McCullough AJ. Pathogenesis of non-alcoholic steatohepatitis: human data. Clin Liver Dis. 2007;11(1):75–104. doi:10.1016/j.cld.2007.02.011. ix.

    Article  PubMed  Google Scholar 

  17. Yeh MM, Brunt EM. Pathology of nonalcoholic fatty liver disease. Am J Clin Pathol. 2007;128(5):837–847. doi:10.1309/RTPM1PY6YGBL2G2R.

    Article  PubMed  Google Scholar 

  18. Tsai CJ, Leitzmann MF, Willett WC, et al. Prospective study of abdominal adiposity and gallstone disease in US men. Am J Clin Nutr. 2004;80(1):38–44.

    PubMed  CAS  Google Scholar 

  19. Grundy SM. Cholesterol gallstones: a fellow traveler with metabolic syndrome? Am J Clin Nutr. 2004;80(1):1–2.

    PubMed  CAS  Google Scholar 

  20. Tsai CJ, Leitzmann MF, Willett WC, et al. Central adiposity, regional fat distribution, and the risk of cholecystectomy in women. Gut. 2006;55(5):708–714. doi:10.1136/gut.2005.076133.

    Article  PubMed  Google Scholar 

  21. Goldblatt MI, Swartz-Basile DA, Al-Azzawi HH, et al. Nonalcoholic fatty gallbladder disease: the influence of diet in lean and obese mice. J Gastrointest Surg. 2006;10(2):193–201. doi:10.1016/j.gassur.2005.07.009.

    Article  PubMed  Google Scholar 

  22. Hsu IR, Kim SP, Kabir M, et al. Metabolic syndrome, hyperinsulinemia, and cancer. Am J Clin Nutr. 2007;86(3):s867–s871.

    PubMed  Google Scholar 

  23. El-Serag H. Role of obesity in GORD-related disorders. Gut. 2008;57(3):281–284. doi:10.1136/gut.2007.127878.

    Article  PubMed  Google Scholar 

  24. Fontana L, Klein S. Aging, adiposity, and calorie restriction. JAMA. 2007;297(9):986–994. doi:10.1001/jama.297.9.986.

    Article  PubMed  CAS  Google Scholar 

  25. Weiss R. Fat distribution and storage: how much, where, and how? Eur J Endocrinol. 2007;157(suppl 1):S39–S45. doi:10.1530/EJE-07-0125.

    Article  PubMed  CAS  Google Scholar 

  26. Arner P. Not all fat is alike. Lancet. 1998;351(9112):1301–1302. doi:10.1016/S0140-6736(05)79052-8.

    Article  PubMed  CAS  Google Scholar 

  27. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection. Evaluation, and treatment of high blood cholesterol in adults (Adult treatment Panel III) final report. Circulation. 2002;106:3143–3421.

    Google Scholar 

  28. Yudkin JS. Inflammation, obesity, and the metabolic syndrome. Horm Metab Res. 2007;39(10):707–709. doi:10.1055/s-2007-985898.

    Article  PubMed  CAS  Google Scholar 

  29. Schäffler A, Schölmerich J, Büchler C. Mechanisms of disease: adipocytokines and visceral adipose tissue—emerging role in nonalcoholic fatty liver disease. Nat Clin Pract Gastroenterol Hepatol. 2005;2(6):273–280. doi:10.1038/ncpgasthep0186.

    Article  PubMed  Google Scholar 

  30. Pou KM, Massaro JM, Hoffmann U, et al. Visceral and subcutaneous adipose tissue volumes are cross-sectionally related to markers of inflammation and oxidative stress: the Framingham Heart Study. Circulation. 2007;116(11):1234–1241. doi:10.1161/CIRCULATIONAHA.107.710509.

    Article  PubMed  CAS  Google Scholar 

  31. You T, Nicklas BJ. Chronic inflammation: role of adipose tissue and modulation by weight loss. Curr Diabetes Rev. 2006;2(1):29–37. doi:10.2174/157339906775473626.

    Article  PubMed  Google Scholar 

  32. Hamdy O, Porramatikul S, Al-Ozairi E. Metabolic obesity: the paradox between visceral and subcutaneous fat. Curr Diabetes Rev. 2006;2(4):367–373.

    PubMed  Google Scholar 

  33. Bergman RN, Kim SP, Catalano KJ, et al. Why visceral fat is bad: mechanisms of the metabolic syndrome. Obesity (Silver Spring). 2006;14(suppl 1):16S–19S. doi:10.1038/oby.2006.277.

    Article  CAS  Google Scholar 

  34. Matsuzawa Y, Shimomura I, Kihara S, et al. Importance of adipocytokines in obesity-related diseases. Horm Res. 2003;60(suppl 3):56–59. doi:10.1159/000074502.

    Article  PubMed  CAS  Google Scholar 

  35. Keus F, de Jong JA, Gooszen HG, et al. Laparoscopic versus open cholecystectomy for patients with symptomatic cholecystolithiasis. Cochrane Database Syst Rev. 2006;(4):CD006231.

  36. Aidonopoulos AP, Papavramidis ST, Zaraboukas TG, et al. Gallbladder findings after cholecystectomy in morbidly obese patients. Obes Surg. 1994;4(1):8–12. doi:10.1381/096089294765558827.

    Article  PubMed  Google Scholar 

  37. Everhart JE. Contributions of obesity and weight loss to gallstone disease. Ann Intern Med. 1993;119(10):1029–1035.

    PubMed  CAS  Google Scholar 

  38. Haffner SM, Diehl AK, Stern MP, et al. Central adiposity and gallbladder disease in Mexican Americans. Am J Epidemiol. 1989;129(3):587–595.

    PubMed  CAS  Google Scholar 

  39. Dittrick GW, Thompson JS, Campos D, et al. Gallbladder pathology in morbid obesity. Obes Surg. 2005;15(2):238–242. doi:10.1381/0960892053268273.

    Article  PubMed  Google Scholar 

  40. Ruhl CE, Everhart JE. Relationship of serum leptin concentration and other measures of adiposity with gallbladder disease. Hepatology. 2001;34:877–883. doi:10.1053/jhep.2001.29005.

    Article  PubMed  CAS  Google Scholar 

  41. Heaton KW, Braddon FEM, Emmett PM, et al. Why do men get gallstones? Roles of abdominal fat and hyperinsulinemia. Eur J Gastroenterol Hepatol. 1991;3:745–751.

    Google Scholar 

  42. Hendel HW, Højgaard L, Andersen T, et al. Fasting gall bladder volume and lithogenicity in relation to glucose tolerance, total and intra-abdominal fat masses in obese non-diabetic subjects. Int J Obes Relat Metab Disord. 1998;22(4):294–302. doi:10.1038/sj.ijo.0800583.

    Article  PubMed  CAS  Google Scholar 

  43. Petroni ML. Gallbladder motor function in obesity. Aliment Pharmacol Ther. 2000;14(suppl 2):48–50. doi:10.1046/j.1365-2036.2000.014s2048.x.

    Article  PubMed  Google Scholar 

  44. Mathus-Vliegen EM, Van Ierland-Van Leeuwen ML, Terpstra A. Determinants of gallbladder kinetics in obesity. Dig Dis Sci. 2004;49(1):9–16. doi:10.1023/B:DDAS.0000011595.39555.c0.

    Article  PubMed  CAS  Google Scholar 

  45. Gielkens HA, Lam WF, Coenraad M, et al. Effect of insulin on basal and cholecystokinin-stimulated gallbladder motility in humans. J Hepatol. 1998;28:595–602. doi:10.1016/S0168-8278(98)80282-1.

    Article  PubMed  CAS  Google Scholar 

  46. Wright D, Sutherland L. Antioxidant supplemention in the treatment of skeletal muscle insulin resistance: potential mechanisms and clinical relevance. Appl Physiol Nutr Metab. 2008;33(1):21–31. doi:10.1139/H07-155.

    Article  PubMed  CAS  Google Scholar 

  47. Portincasa P, Di Ciaula A, van Berge-Henegouwen GP. Smooth muscle function and dysfunction in gallbladder disease. Curr Gastroenterol Rep. 2004;6(2):151–162. doi:10.1007/s11894-004-0043-0.

    Article  PubMed  Google Scholar 

  48. Nepokroeff CM, Lakshmanan MR, Ness GC, et al. Regulation of the diurnal rhythm of rat liver beta-hydroxy-beta-methylglutaryl coenzyme A reductase activity by insulin, glucagon, cyclic AMP and hydrocortisone. Arch Biochem Biophys. 1974;160:387–396. doi:10.1016/0003-9861(74)90412-3.

    Article  PubMed  CAS  Google Scholar 

  49. Chait A, Bierman EL, Albers JJ. Low-density lipoprotein receptor activity in cultured human skin fibroblasts. Mechanism of insulin-induced stimulation. J Clin Invest. 1979;64:1309–1319. doi:10.1172/JCI109587.

    Article  PubMed  CAS  Google Scholar 

  50. Nakeeb A, Comuzzie AG, Al-Azzawi H, et al. Insulin resistance causes human gallbladder dysmotility. J Gastrointest Surg. 2006;10(7):940–948. doi:10.1016/j.gassur.2006.04.005.

    Article  PubMed  Google Scholar 

  51. Tran KQ, Goldblatt MI, Swartz-Basile DA, et al. Diabetes and hyperlipidemia correlate with gallbladder contractility in leptin-related murine obesity. J Gastrointest Surg. 2003;7(7):857–862. doi:10.1007/s11605-003-0030-z.

    Article  PubMed  Google Scholar 

  52. Al-Azzawi HH, Mathur A, Lu D, et al. Resistin-like molecule alpha reduces gallbladder optimal tension. J Gastrointest Surg. 2007;11(1):95–100. doi:10.1007/s11605-006-0039-1.

    Article  PubMed  Google Scholar 

  53. George J, Baillie J. Biliary and gallbladder dyskinesia. Curr Treat Options Gastroenterol. 2007;10(4):322–327. doi:10.1007/s11938-007-0075-2.

    Article  PubMed  Google Scholar 

  54. Mallon P, White J, McMenamin M, et al. Increased cholecystectomy rate in the laparoscopic era: a study of the potential causative factors. Surg Endosc. 2006;20(6):883–886. doi:10.1007/s00464-005-0598-3.

    Article  PubMed  CAS  Google Scholar 

  55. Johanning JM, Gruenberg JC. The changing face of cholecystectomy. Am Surg. 1998;64(7):643–647.

    PubMed  CAS  Google Scholar 

  56. Al-Azzawi HH, Nakeeb A, Saxena R, et al. Cholecystosteatosis: an explanation for increased cholecystectomy rates. J Gastrointest Surg. 2007;11(7):835–842. doi:10.1007/s11605-007-0169-0.

    Article  PubMed  Google Scholar 

  57. Goldblatt MI, Swartz-Basile DA, Svatek CL, et al. Decreased gallbladder response in leptin-deficient obese mice. J Gastrointest Surg. 2002;6(3):438–442. doi:10.1016/S1091-255X(01)00046-4.

    Article  PubMed  Google Scholar 

  58. Graewin SJ, Kiely JM, Lu D, et al. Leptin regulates gallbladder genes related to gallstone pathogenesis in leptin-deficient mice. J Am Coll Surg. 2008;206(3):503–510.

    PubMed  Google Scholar 

  59. Swartz-Basile DA, Lu D, Basile DP, et al. Leptin regulates gallbladder genes related to absorption and secretion. Am J Physiol Gastrointest Liver Physiol. 2007;293(1):G84–G90. doi:10.1152/ajpgi.00389.2006.

    Article  PubMed  CAS  Google Scholar 

  60. Patel SB. Ezetimibe: a novel cholesterol-lowering agent that highlights novel physiologic pathways. Curr Cardiol Rep. 2004;6:439–442. doi:10.1007/s11886-004-0052-5.

    Article  PubMed  Google Scholar 

  61. Mathur A, Walker JJ, Al-Azzawi HH, et al. Ezetimibe ameliorates cholecystosteatosis. Surgery. 2007;142(2):228–233. doi:10.1016/j.surg.2007.04.007.

    Article  PubMed  Google Scholar 

  62. Gilloteaux J, Tomasello LM, Elgison DA. Lipid deposits and lipo-mucosomes in human cholecystitis and epithelial metaplasia in chronic cholecystitis. Ultrastruct Pathol. 2003;27(5):313–321. doi:10.1080/716100787.

    Article  PubMed  Google Scholar 

  63. Mathur A, Al-Azzawi HH, Lu D, et al. Steatocholecystitis: the influence of obesity and dietary carbohydrates. J Surg Res. 2008;147(2):290–297. doi:10.1016/j.jss.2007.04.042.

    Article  PubMed  CAS  Google Scholar 

  64. Xiao ZL, Amaral J, Biancani P, et al. Impaired cytoprotective function of muscle in human gallbladders with cholesterol stones. Am J Physiol Gastrointest Liver Physiol. 2005;288(3):G525–G532. doi:10.1152/ajpgi.00261.2004.

    Article  PubMed  CAS  Google Scholar 

  65. Yu P, Chen Q, Biancani P, et al. Membrane cholesterol alters gallbladder muscle contractility in prairie dogs. Am J Physiol. 1996;271(1 Pt 1):G56–G61.

    PubMed  CAS  Google Scholar 

  66. Chen Q, Amaral J, Biancani P, et al. Excess membrane cholesterol alters human gallbladder muscle contractility and membrane fluidity. Gastroenterology. 1999;116(3):678–685. doi:10.1016/S0016-5085(99)70190-3.

    Article  PubMed  CAS  Google Scholar 

  67. Xiao ZL, Chen Q, Amaral J, et al. CCK receptor dysfunction in muscle membranes from human gallbladders with cholesterol stones. Am J Physiol. 1999;276(6 Pt 1):G1401–G1407.

    PubMed  CAS  Google Scholar 

  68. Tilg H, Hotamisligil GS. Nonalcoholic fatty liver disease: cytokine-adipokine interplay and regulation of insulin resistance. Gastroenterology. 2006;131(3):934–945. doi:10.1053/j.gastro.2006.05.054.

    Article  PubMed  CAS  Google Scholar 

  69. Hotamisligil GS, Shargill NS, Spiegelman BM. Adipose expression of tumor necrosis factor-alpha: direct role in obesity-linked insulin resistance. Science. 1993;259(5091):87–91. doi:10.1126/science.7678183.

    Article  PubMed  CAS  Google Scholar 

  70. Rege RV. Inflammatory cytokines alter human gallbladder epithelial cell absorption/secretion. J Gastrointest Surg. 2000;4(2):185–192. doi:10.1016/S1091-255X(00)80055-4.

    Article  PubMed  CAS  Google Scholar 

  71. Rege RV, Prystowsky JB. Inflammation and a thickened mucus layer in mice with cholesterol gallstones. J Surg Res. 1998;74(1):81–85. doi:10.1006/jsre.1997.5213.

    Article  PubMed  CAS  Google Scholar 

  72. Finzi L, Barbu V, Burgel PR, et al. MUC5AC, a gel-forming mucin accumulating in gallstone disease, is overproduced via an epidermal growth factor receptor pathway in the human gallbladder. Am J Pathol. 2006;169(6):2031–2041. doi:10.2353/ajpath.2006.060146.

    Article  PubMed  CAS  Google Scholar 

  73. Wang HH, Afdhal NH, Gendler SJ, et al. Evidence that gallbladder epithelial mucin enhances cholesterol cholelithogenesis in MUC1 transgenic mice. Gastroenterology. 2006;131(1):210–222. doi:10.1053/j.gastro.2006.04.011.

    Article  PubMed  CAS  Google Scholar 

  74. Larsson SC, Wolk A. Obesity and the risk of gallbladder cancer: a meta-analysis. Br J Cancer. 2007;96(9):1457–1461.

    PubMed  CAS  Google Scholar 

  75. Renehan AG, Tyson M, Egger M, et al. Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies. Lancet. 2008;371(9612):569–578. doi:10.1016/S0140-6736(08)60269-X.

    Article  PubMed  Google Scholar 

  76. Bugianesi E. Steatosis, the metabolic syndrome and cancer. Aliment Pharmacol Ther. 2005;22(suppl 2):40–43. doi:10.1111/j.1365-2036.2005.02594.x.

    Article  PubMed  Google Scholar 

  77. Wistuba II, Gazdar AF. Gallbladder cancer: lessons from a rare tumour. Nat Rev Cancer. 2004;4(9):695–706. doi:10.1038/nrc1429.

    Article  PubMed  CAS  Google Scholar 

  78. Miller G, Jarnagin WR. Gallbladder carcinoma. Eur J Surg Oncol. 2008;34(3):306–312. doi:10.1016/j.ejso.2007.07.206.

    PubMed  CAS  Google Scholar 

  79. Randi G, Franceschi S, La Vecchia C. Gallbladder cancer worldwide: geographical distribution and risk factors. Int J Cancer. 2006;118(7):1591–1602. doi:10.1002/ijc.21683.

    Article  PubMed  CAS  Google Scholar 

  80. Perwez Hussain S, Harris CC. Inflammation and cancer: an ancient link with novel potentials. Int J Cancer. 2007;121(11):2373–2380. doi:10.1002/ijc.23173.

    Article  PubMed  Google Scholar 

  81. Ying L, Hofseth LJ. An emerging role for endothelial nitric oxide synthase in chronic inflammation and cancer. Cancer Res. 2007;67(4):1407–1410. doi:10.1158/0008-5472.CAN-06-2149.

    Article  PubMed  CAS  Google Scholar 

  82. Kanoh K, Shimura T, Tsutsumi S, et al. Significance of contracted cholecystitis lesions as high risk for gallbladder carcinogenesis. Cancer Lett. 2001;169(1):7–14. doi:10.1016/S0304-3835(01)00523-7.

    Article  PubMed  CAS  Google Scholar 

  83. Kitasato A, Tajima Y, Kuroki T, et al. Inflammatory cytokines promote inducible nitric oxide synthase-mediated DNA damage in hamster gallbladder epithelial cells. World J Gastroenterol. 2007;13(47):6379–6384. doi:10.3748/wjg.13.6379.

    Article  PubMed  CAS  Google Scholar 

  84. Kawanishi S, Hiraku Y, Pinlaor S, et al. Oxidative and nitrative DNA damage in animals and patients with inflammatory diseases in relation to inflammation-related carcinogenesis. Biol Chem. 2006;387(4):365–372. doi:10.1515/BC.2006.049.

    Article  PubMed  CAS  Google Scholar 

  85. Sawa T, Ohshima H. Nitrative DNA damage in inflammation and its possible role in carcinogenesis. Nitric Oxide. 2006;14(2):91–100. doi:10.1016/j.niox.2005.06.005.

    Article  PubMed  CAS  Google Scholar 

  86. Bugianesi E. Non-alcoholic steatohepatitis and cancer. Clin Liver Dis. 2007;11(1):191–207. doi:10.1016/j.cld.2007.02.006. x-xi.

    Article  PubMed  CAS  Google Scholar 

  87. Marra F, Gastaldelli A, Svegliati Baroni G, et al. Molecular basis and mechanisms of progression of non-alcoholic steatohepatitis. Trends Mol Med. 2008;14(2):72–81. doi:10.1016/j.molmed.2007.12.003.

    Article  PubMed  CAS  Google Scholar 

  88. Tsai CJ, Leitzmann MF, Willett WC, et al. Glycemic load, glycemic index, and carbohydrate intake in relation to risk of cholecystectomy in women. Gastroenterology. 2005;129(1):105–112. doi:10.1053/j.gastro.2005.05.016.

    Article  PubMed  Google Scholar 

  89. Ko CW, Lee SP. Dietary carbohydrates and gallstones: is there a link? Gastroenterology. 2005;129(1):373–375. doi:10.1053/j.gastro.2005.05.042.

    Article  PubMed  Google Scholar 

  90. Tsai CJ, Leitzmann MF, Willett WC, et al. Dietary carbohydrates and glycaemic load and the incidence of symptomatic gall stone disease in men. Gut. 2005;54(6):823–828. doi:10.1136/gut.2003.031435.

    Article  PubMed  CAS  Google Scholar 

  91. Shea JA, Berlin JA, Bachwich DR, et al. Indications for and outcomes of cholecystectomy: a comparison of the pre- and post-laparoscopic eras. Ann Surg. 1998;227(3):343–350. doi:10.1097/00000658-199803000-00005.

    Article  PubMed  CAS  Google Scholar 

  92. Escarce JJ, Chen W, Schwartz JS. Falling cholecystectomy thresholds since the introduction of laparoscopic cholecystectomy. JAMA. 1995;273(20):1581–1585. doi:10.1001/jama.273.20.1581.

    Article  PubMed  CAS  Google Scholar 

  93. McGavock JM, Lingvay I, Zib I, et al. Cardiac steatosis in diabetes mellitus: a 1H-magnetic resonance spectroscopy study. Circulation. 2007;116(10):1170–1175. doi:10.1161/CIRCULATIONAHA.106.645614.

    Article  PubMed  Google Scholar 

  94. Reingold JS, McGavock JM, Kaka S, et al. Determination of triglyceride in the human myocardium by magnetic resonance spectroscopy: reproducibility and sensitivity of the method. Am J Physiol Endocrinol Metab. 2005;289(5):E935–E939. doi:10.1152/ajpendo.00095.2005.

    Article  PubMed  CAS  Google Scholar 

  95. Szczepaniak LS, Dobbins RL, Metzger GJ, et al. Myocardial triglycerides and systolic function in humans: in vivo evaluation by localized proton spectroscopy and cardiac imaging. Magn Reson Med. 2003;49(3):417–423. doi:10.1002/mrm.10372.

    Article  PubMed  CAS  Google Scholar 

  96. Thomas EL, Hamilton G, Patel N, et al. Hepatic triglyceride content and its relation to body adiposity: a magnetic resonance imaging and proton magnetic resonance spectroscopy study. Gut. 2005;54(1):122–127. doi:10.1136/gut.2003.036566.

    Article  PubMed  CAS  Google Scholar 

  97. Szczepaniak LS, Nurenberg P, Leonard D, et al. Magnetic resonance spectroscopy to measure hepatic triglyceride content: prevalence of hepatic steatosis in the general population. Am J Physiol Endocrinol Metab. 2005;288(2):E462–E468. doi:10.1152/ajpendo.00064.2004.

    Article  PubMed  CAS  Google Scholar 

  98. Szczepaniak LS, Dobbins RL, Stein DT, et al. Bulk magnetic susceptibility effects on the assessment of intra- and extra-myocellular lipids in vivo. Magn Reson Med. 2002;47(3):607–610. doi:10.1002/mrm.10086.

    Article  PubMed  CAS  Google Scholar 

  99. Boesch C, Slotboom J, Hoppeler H, et al. In vivo determination of intra-myocellular lipids in human muscle by means of localized 1H-MR-spectroscopy. Magn Reson Med. 1997;37(4):484–493. doi:10.1002/mrm.1910370403.

    Article  PubMed  CAS  Google Scholar 

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  1. Division of Digestive Diseases and Nutrition, University of Kentucky Medical Center, 800 Rose Street, Lexington, Kentucky, 40536-0298, USA

    Chung-Jyi Tsai

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Tsai, CJ. Steatocholecystitis and Fatty Gallbladder Disease. Dig Dis Sci 54, 1857–1863 (2009). https://doi.org/10.1007/s10620-008-0578-2

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  • DOI: https://doi.org/10.1007/s10620-008-0578-2

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