Abstract

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. © 2006 European Association for the Study of the Liver.