Abstract

BACKGROUND AND AIMS: Presence of gallstone disease may influence outcomes in patients with nonalcoholic fatty liver disease (NAFLD). We studied the impact of gallstone disease on mortality in individuals with and without NAFLD.METHODS: Prospective cohort study using the Third National Health and Nutrition Examination Survey (1988-1994) with mortality data through 2015. Gallstone disease was defined as ultrasonographic evidence of gallstones or absence of the gallbladder (prior cholecystectomy). NAFLD was defined using standardized ultrasonographic criteria.RESULTS: Gallstone disease and cholecystectomy were independently associated with NAFLD (odds ratio [OR]: 1.75, 95% confidence interval [CI]: 1.43-2.15 for gallstone disease and OR: 2.77, 95% CI: 2.01-3.83 for cholecystectomy compared to no gallstone disease). During the median follow-up of 23 years, gallstone disease was associated with a higher risk of overall all-cause mortality (hazard ratio [HR]: 1.19, 95% CI: 1.05-1.37) and cause-specific mortality. Gallstone disease was associated with a higher risk of all-cause mortality in non-NAFLD sub-cohort (HR: 1.42, 95% CI 1.23-1.64), but not in NAFLD (HR: 1.03, 95% CI: 0.87-1.22). Gallstone disease was associated with a higher risk of cardiovascular (HR: 1.40, 95% CI 1.10-1.78) and cancer (HR: 1.71, 95% CI: 1.18-2.48)-related mortality in non-NAFLD sub-cohort. Gallstone disease was associated with increased cardiovascular mortality (HR: 1.36, 95% CI: 1.05-1.77) in NAFLD.CONCLUSION: Gallstone disease is an independent risk factor for NAFLD, but gallstone disease is not associated with all-cause mortality in individuals with NAFLD. Screening for gallstone disease in individuals at risk for developing NAFLD may help with risk stratification for all-cause mortality related to gallstone disease.

View details for DOI 10.1016/j.cgh.2022.04.043

View details for PubMedID 35643414