Abstract

Background: Cholelithiasis and Non-alcoholic fatty liver disease (NAFLD) are two of the most prevalent diseases in the general population. Both diseases are associated with insulin resistance and metabolic syndrome. Objectives: The aims of this study were to evaluate the prevalence of gallstone disease in NAFLD patients and define the correlation of gallstone disease with different grades of NAFLD. Also the correlation of NAFLD and gallstone disease was evaluated regarding patient age, gender and BMI. Methods: Persons between 20 to 60 years referring to the radiology department for abdominal ultrasound participated in this study. The diagnosis of gallstone disease was made according to ultrasound criteria. Results and conclusion: 1253 patients (42% male and 58% female) participated in our study. Fatty liver was diagnosed in 59% of patients, with a significant increase in its prevalence in men (p-value 0.025). No significant difference was seen in prevalence of different grades of fatty liver in the two genders. Gallstone disease was diagnosed in 35% of men and 36% of women; no significant difference was seen in the prevalence of gallstone disease between the two genders. A weak correlation with correlation coefficient of 0.23 was detected between fatty liver and gallstone disease. Correlation was slightly more in women than in men. The prevalence of gallstone disease is higher in more severe grades of fatty liver.  A weak correlation was seen between age and fatty liver and also with its grade. A weak positive correlation was seen between gallstone disease and age in women but it was not depicted in men. There was a positive correlation (p-value < 0.001) between higher BMI and existence of fatty liver. A strong correlation was identified between higher grades of fatty liver and upper values of BMI (correlation coefficient: 0.67, p-value <0.001). A weak correlation was shown between higher BMI levels and gallstone disease (correlation coefficient: 0.15, p-value <0.001). Patients with NAFLD had a higher prevalence of gallstone disease than the general population, thus gallstone disease and NAFLD are in the domain of metabolic syndrome with the same risk factors. The correlation of NAFLD and gallstone disease was stronger in women, showing that gender-specific reactions have an important role in the physiological response to insulin resistance.