Association of Cholecystectomy With Liver Fibrosis and Cirrhosis Among Adults in the USA: A Population-Based Propensity Score-Matched Study.
Association of Cholecystectomy With Liver Fibrosis and Cirrhosis Among Adults in the USA: A Population-Based Propensity Score-Matched Study.
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DOI：
10.3389/fmed.2021.787777
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发表时间：
2021
影响因子：
3.9
通讯作者：
Chen YJ
中科院分区：
文献类型：
--
作者：
Xie ZQ;Li HX;Tan WL;Yang L;Ma XW;Li WX;Wang QB;Shang CZ;Chen YJ
背景和目的：胆囊切除术是治疗胆囊病的“金标准”。此外，非酒精性脂肪性肝病(NAFLD)、肝纤维化或肝硬变是全世界发病率和死亡率的主要原因。然而，胆囊切除术和这些疾病之间的联系仍然不清楚。我们评估了美国成年人之间的关联，并检查了可能的风险因素。方法：这项横断面研究使用了2017-2018年美国全国健康与营养调查的数据，这是一个以人口为基础的具有全国代表性的样本。肝纤维化和肝硬变的定义是通过瞬时弹性成像评估的中位硬度。此外，根据问卷确定了接受过胆囊切除术的患者。此外，根据性别、年龄、体重指数(BMI)和糖尿病进行倾向评分匹配(PSM，1：1)。结果：在4,497名受试者中，胆囊切除与肝纤维化风险增加60.0%(OR：1.600；95%CI：1.278-2.002)，与肝硬变风险增加73.3%(OR：1.733，95%CI：1.076-2.792)相关。根据年龄、性别、体重指数组和糖尿病病史进行治疗后，胆囊切除与肝纤维化风险增加139.3%(OR：2.393；95%CI：1.738~3.297)和肝硬变风险增加228.7%(OR：3.287，95%CI：1.496~7.218)相关。结论：目前的研究表明，在美国成年人中，胆囊切除术与肝纤维化和肝硬变呈正相关。因此，这些危险因素的发现为预防非酒精性脂肪肝、肝纤维化和肝硬变提供了新的见解。
Background and Aims: Cholecystectomy is the “gold standard” for treating diseases of the gallbladder. In addition, non-alcoholic fatty liver disease (NAFLD), liver fibrosis or cirrhosis, are major causes of morbidity and mortality across the world. However, the association between cholecystectomy and these diseases is still unclear. We assessed the association among US adults and examined the possible risk factors. Methods: This cross-sectional study used data from 2017 to 2018 National Health and Nutrition Examination Survey, a population-based nationally representative sample of US. Liver fibrosis and cirrhosis were defined by median stiffness, which was assessed by transient elastography. Furthermore, patients who had undergone cholecystectomy were identified based on the questionnaire. In addition, Propensity Score Matching (PSM, 1:1) was performed based on gender, age, body mass index (BMI) and diabetes. Results: Of the 4,497 included participants, cholecystectomy was associated with 60.0% higher risk of liver fibrosis (OR:1.600;95% CI:1.278–2.002), and 73.3% higher risk of liver cirrhosis (OR:1.733, 95% CI:1.076–2.792). After PSM based on age, gender, BMI group and history of diabetes, cholecystectomy was associated with 139.3% higher risk of liver fibrosis (OR: 2.393;95% CI: 1.738–3.297), and 228.7% higher risk of liver cirrhosis (OR: 3.287, 95% CI: 1.496–7.218). Conclusions: The present study showed that cholecystectomy is positively associated with liver fibrosis and cirrhosis in US adults. The discovery of these risk factors therefore provides new insights on the prevention of NAFLD, liver fibrosis, and cirrhosis.
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通讯作者：
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