Indian Journal of Medical Biochemistry

Register      Login

VOLUME 23 , ISSUE 1 ( January-April, 2019 ) > List of Articles

CASE REPORT

Silent Gallbladder Stone Associated with Nonalcoholic Fatty Liver Disease in a Scenario of Insulin Resistance in Young Adults

Samarpita Mukherjee, Arup K Banerjee, Swati Bhattacharyya, Shubhrajit Saha

Keywords : BMI, Dyslipidemia, Hyperinsulinemia, Gallstone disease, Insulin resistance, Metabolic syndrome, NAFLD

Citation Information : Mukherjee S, Banerjee AK, Bhattacharyya S, Saha S. Silent Gallbladder Stone Associated with Nonalcoholic Fatty Liver Disease in a Scenario of Insulin Resistance in Young Adults. Indian J Med Biochem 2019; 23 (1):226-229.

DOI: 10.5005/jp-journals-10054-0091

License: CC BY-NC 4.0

Published Online: 01-04-2019

Copyright Statement:  Copyright © 2019; The Author(s).


Abstract

Nonalcoholic fatty liver disease (NAFLD) is considered as the hepatic expression of insulin resistance. The high occurrence of obesity and dyslipidaemia in insulin resistant condition favours NAFLD. The hepatic effect of insulin resistance are diverse including increased hepatic cholesterol secretion, biliary cholesterol supersaturation and decreased biliary motility all of which leads to gallstone formation. NAFLD and gallstone disease (GSD) shares common pathological factors like hyperinsulinemia, dyslipidaemia. As all the factors are common association with Insulin resistance there could be common occurrence of NAFLD and GSD in patients with insulin resistance. During a study two patients with insulin resistance were found to have both NAFLD and GSD. Both the patients were found to be dyslipidemic and on sonography one was found to have multiple gall bladder stones and the other with a single gall bladder stone.


PDF Share
  1. Fracanzani AL, Valenti L, Russello M, et al. Gallstone Disease Is Associated with More Severe Liver Damage in Patients with Non- Alcoholic Fatty Liver Disease. PLoS ONE 2012;(7):e41183. doi:10.1371/ journal.pone.0041183
  2. Angulo P. Nonalcoholic fatty liver disease. N Engl J Med 2002;346:1221- 1231.
  3. Bugianesi E, Leone N, Vanni E, et al. Expanding the natural history of nonalcoholic steatohepatitis: From cryptogenic cirrhosis to hepatocellular carcinoma. Gastroenterology 2002;123:134-140.
  4. Adams LA, Waters OR, Knuiman MW, et al. NAFLD as a risk factor for the development of diabetes and the metabolic syndrome: an eleven-year follow-up study. Am J Gastroenterol2009:104:861-867.
  5. Tsai CJ, Leitzmann MF, Willett WC, et al. Macronutrients and insulin resistance in cholesterol gallstone disease. Am J Gastroenterol2008; 103:2932-2939.
  6. Grundy SM, Brewer HB Jr, Cleeman JI, et al. Definition of metabolic syndrome: Report of the National Heart, Lung, and Blood Institute/ American Heart Association conference on scientific issues related to definition. Circulation 2004;109: 433-438.
  7. Dhumal UM, Madole MB, Aher JB. Comparison of lipid profile in different grades of non-alcoholic fatty liver disease diagnosed on ultrasound. Asian Pac J Trop Biomed 2013;3:907-912
  8. Kabir IM, Alam M, Mohammad M, et al. Correlation between bright echogenic liver, elevated liver enzymes and liver histology. J Dhaka National Med Coll Hos 2011;17:8-13.
  9. Angulo P, Keach JC, Batts KP, et al. Independent predictors of liver fibrosis in patients with nonalcoholic steatohepatitis. Hepatology 1999;30:1356-1362.
  10. Diz PG, Alvarez MXR, Gude F, et al. Insulin Resistance cut off values and metabolic syndrome in general a adult population. BMC endocrine disorder 2013;13:47-54.
  11. Eckel RH. The metabolic Syndrome. In, Kasper DL, Hauser SL, Jameson JL, Fauci AS, Longo D L, Loscalzo J (ed). Harrison's principles of Internal Medicine, 19th edition. U.S, McGraw-Hill Education 2015; 2449-2451.
  12. Setsi G. Pathology of insulin resistance Bust. Pract Res Clin Endocrinal Metab. 2006;20(4):665-679.
  13. Paschos P, Paletas K. Non alcoholic fatty liver disease and metabolic syndrome. Hippokratia 2009 Jan;13(1):9.
  14. Day CP. Non-alcoholic steatohepatitis (NASH): where are we now and where are we going?. Gut. 2002 May 1;50(5):585-588.
  15. Donnelly KL, Smith CI, Schwarzenberg SJ, et al. Sources of fatty acids stored in liver and secreted via lipoproteins in patients with nonalcoholic fatty liver disease. The Journal of Clinical Investigation 2005 May 2;115(5):1343-1351.
  16. Sanyal AJ. Mechanisms of Disease: pathogenesis of nonalcoholic fatty liver disease. Nat Clin Pract Gastroenterol Hepatol. 2005;2:46-53.
  17. Biddinger SB, Haas JT, Yu BB, Bezy O, Jing E, et al. Hepatic insulin resistance directly promotes formation of cholesterol gallstones. Nat Med2008;14:778-782.
  18. Loria P, Lonardo A, Lombardini S, et al. Gallstone disease in non-alcoholic fatty liver: prevalence and associated factors. J Gastroenterol Hepatol2005; 20: 1176–84.
  19. Oktay Y, Fikret A, Mustafa D, et al. Gallstones associated with nonalcoholic steatohepatitis (NASH) and metabolic syndrome. Turk J Gastroenterol 2010; 21 (4): 411-415.
  20. Bae JC, Suh S, Park SE, et al. Regular Exercise Is Associated with a Reduction in the Risk of NAFLD and Decreased Liver Enzymes in Individuals with NAFLD Independent of Obesity in Korean Adults. PLoS ONE. 2012; 7(10):e46819.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.