Gallbladder disease is associated with insulin resistance in a high risk Hispanic population

Background/Aims: We tested whether cholesterol gallstone disease (GS) is associated to insulin resistance and serum C-reactive protein (CRP) in a high risk population. Methods:This was a nested case-control study on 881 Chilean subjects that included clinical examination, abdominal ultrasound and blood chemistries. Insulin resistance was determined by the homeostasis model assessment index (IR-(HOMA)). Results: Compared to controls (n = 582), age and sex adjusted median IR-HOMA was significantly elevated in subjects with GS (n = 299) (P < 0.001). Risks of GS in subjects with insulin resistance and different body mass index (BMI) were: BMI < 25, 2.2 (1.1-4.7); BMI 25-30, 1.5 (0.9-2.5) and BMI > 30, 1.7 (1.0-2.9). Risk of GS in subjects with metabolic syndrome was 1.7 (CI, 1.2-2.5) and with fatty liver, 1.5 (1.1-2.2). Risk of GS in subjects with CRP > 1 mg/dL was 1.0 (0.7-1.7). Conclusions: GS is associated to insulin resistance, fatty liver and to metabolic syndrome, but not to serum CRP in a high risk Hispanic population. Insulin resistance could have a major role in the pathogenesis of GS favoring the production of cholesterol supersaturated bile and altering gallbladder function. (c) 2006 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.