Obesity and the risk and prognosis of gallstone disease and pancreatitis
Obesity and the risk and prognosis of gallstone disease and pancreatitis
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DOI：
10.1016/j.bpg.2014.07.013
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发表时间：
2014-08-01
影响因子：
3.2
通讯作者：
Portincasa, Piero
中科院分区：
文献类型：
--
作者：
Bonfrate, Leonilde;Wang, David Q-H.;Portincasa, Piero
肥胖是胆固醇结石形成的一个危险因素，并使患者面临胆结石相关并发症和胆囊切除术的风险增加。通过极低热量饮食或减肥手术实现的快速体重减轻也是肥胖患者胆石症的风险因素，治疗应考虑到胆石症的较高患病率、更频繁并发症的可能性以及在体重减轻期间口服熊去氧胆酸预防性治疗的必要性。儿童和青少年肥胖也很常见，胆固醇结石的负担在这一人群中正在增加。肥胖受试者发生急性胰腺炎的机会和疾病的严重程度更高，因为特定的致病因素，包括过饱和胆汁和晶体形成、快速体重减轻和内脏肥胖。所有旨在减少全世界肥胖症发病率的卫生政策都将减少胆结石和胆结石相关并发症的发病率。病理生理方案和治疗肥胖症，胆石症，胰腺炎的影响进行了讨论。(C)2014爱思唯尔有限公司版权所有。
Obesity is a risk factor for the formation of cholesterol gallstones and exposes patients to increased risk of gallstone-related complications and cholecystectomy. Rapid weight loss achieved by very low calorie diets or bariatric surgery is also a risk factor for cholelithiasis in obese patients, and therapy should take into account the higher prevalence of gallstones, the possibility of more frequent complications and the need for prophylactic treatment with oral ursodeoxycholic acid during weight loss. Obesity is also frequent in children and adolescents, and the burden of cholesterol cholelithiasis is increasing in this population. The chance to develop acute pancreatitis and the severity of the disease are higher in obese subjects because of specific pathogenic factors, including supersaturated bile and crystal formation, rapid weight loss, and visceral obesity. All health policies aimed at reducing the incidence of obesity worldwide will decrease the incidence of gallstones and gallstone-related complications. The pathophysiological scenarios and the therapeutic implications for obesity, gallstone disease, and pancreatitis are discussed. (C) 2014 Elsevier Ltd. All rights reserved.