Alʹmanah Kliničeskoj Mediciny (Dec 2017)
The influence of cholecystectomy at young age on the course of metabolic syndrome in women
Abstract
Rationale: At present, the metabolic syndrome and pathophysiology of non-alcoholic fatty liver disease, as well as identification of factors that may influence the rate of development of dystrophy and fibrosis in the liver are in the focus of investigators' attention. This study represents an attempt to detail metabolic derangements and liver tissue abnormalities after cholecystectomy in patients with metabolic syndrome at baseline.Aim: To study the influence of cholecystectomy performed at younger age on the course of metabolic syndrome in women.Materials and methods: This was a retrospective analytical study in a sample of 57 female patients with metabolic syndrome (International Diabetes Federation criteria 2005) aged from 18 to 44 years (young age according to the World Health Organization definition). From those, 30 patients with cholelithiasis were included into the control group and 27 patients who had undergone cholecystectomy in this age range were included into the comparison group. We analyzed their past history, results of clinical examination, laboratory tests, abdominal ultrasound examination, esophagogastroduodenoscopy, hydrogen respiration test with lactulose, as well as the results of needle liver biopsy.Results: Non-alcoholic steatohepatitis after cholecystectomy was associated with the excessive bacterial growth in the small intestine (р = 0.026), ultrasound signs of cholangitis (р = 0.041), and diarrhea syndrome (р = 0.027). Liver fibrosis was significantly more frequent in association with chronic diarrhea (р = 0.034) and past clinical signs of post-cholecystectomy syndrome (р = 0.044). There was a strong direct correlation between the grade of fibrosis and the time since cholecystectomy (r = 0.77; р = 0.047).Conclusion: Cholecystectomy performed at young age predicts progression of metabolic abnormalities in women with metabolic syndrome.
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