Pathophysiological connections between gallstone disease, insulin resistance, and obesity

Cortés V.A.; Barrera F.; Nervi F.

Abstract

Obesity and cholesterol gallstone disease (GSD) are frequently coexisting diseases; therefore and considering the current worldwide obesity epidemics, a precise understanding of the pathophysiological relationships between GSD and insulin resistance (IR) is important. Classically, obesity has been understood as a risk factor for GSD and the gallbladder (GB) viewed as a simple bile reservoir, with no metabolic roles whatsoever. However, consistent evidence has showed that both GSD and cholecystectomy associates with fatty liver and IR, raising the possibility that the GB is indeed an organ with metabolic regulatory roles. Herein, we review the pathophysiological mechanisms by which GSD, IR, and obesity are interconnected, with emphasis in the actions of the GB as a regulator of bile acids kinetics and a hormone secreting organ, with metabolic actions at the systemic level. We also examine the relationships between increased hepatic lipogenic in IR states and GSD pathogenesis. We propose a model in which GSD and hepatic IR mutually interact to determine a state of dysregulated lipid and energy metabolism that potentiate the metabolic dysregulation of obesity.

Más información

Título según WOS: Pathophysiological connections between gallstone disease, insulin resistance, and obesity
Título según SCOPUS: Pathophysiological connections between gallstone disease, insulin resistance, and obesity
Título de la Revista: OBESITY REVIEWS
Volumen: 21
Número: 4
Editorial: WILEY-BLACKWELL
Fecha de publicación: 2020
Idioma: English
DOI:

10.1111/obr.12983

Notas: ISI, SCOPUS