Explore the vast range of titles available.

The influence of metabolic dysfunction-associated steatotic liver disease (MASLD) on gallbladder polyp development in both sexes remains elusive. Therefore, to clarify the role of MASLD in gallbladder polyp development, we investigated the longitudinal association between MASLD and gallbladder polyps. In this observational study, we included 5,527 gallbladder polyp-free patients who underwent > 2 health check-ups over > 2 years. Generalized estimation equations were used to analyze associations between MASLD and gallbladder polyp development according to repeated measures at baseline and the most recent stage. Gallbladder polyp development rates in men and women were 7.5% and 5.6% ( p  < 0.01), respectively. MASLD was not significantly correlated with gallbladder polyp development. Regarding the association between gallbladder polyp development (men: ≥6 mm and women: ≥5 mm) and the number of MASLD components following lifestyle habits, men and women with ≥ 4 MASLD components had odds ratios of 3.397 (95% confidence interval: 1.096–10.53) and 5.338 (1.054–27.04), respectively. Higher nonalcoholic fatty liver disease fibrosis scores were associated with significant risk of gallbladder polyp development in women (1.991, 1.047–3.785). Although MASLD influence on gallbladder polyp development differs by sex, close monitoring of patients with an increasing number of MASLD components is essential to prevent gallbladder polyp development. Specifically, men with ≥ 4 MASLD components should be monitored for gallbladder polyps measuring ≥ 6 mm.

Little prospective evidence exists about risk factors and prognosis of acute pancreatitis in China. We examined the associations of certain metabolic and lifestyle factors with risk of acute pancreatitis in Chinese adults. The prospective China Kadoorie Biobank (CKB) recruited 512,891 adults aged 30 to 79 years from 5 urban and 5 rural areas between 25 June 2004 and 15 July 2008. During 9.2 years of follow-up (to 1 January 2015), 1,079 cases of acute pancreatitis were recorded. Cox regression was used to estimate adjusted hazard ratios (HRs) for acute pancreatitis associated with various metabolic and lifestyle factors among all or male (for smoking and alcohol drinking) participants. Overall, the mean waist circumference (WC) was 82.1 cm (SD 9.8) cm in men and 79.0 cm (SD 9.5) cm in women, 6% had diabetes, and 6% had gallbladder disease at baseline. WC was positively associated with risk of acute pancreatitis, with an adjusted HR of 1.35 (95% CI 1.27-1.43; p < 0.001) per 1-SD-higher WC. Individuals with diabetes or gallbladder disease had HRs of 1.34 (1.07-1.69; p = 0.01) and 2.42 (2.03-2.88; p < 0.001), respectively. Physical activity was inversely associated with risk of acute pancreatitis, with each 4 metabolic equivalent of task (MET) hours per day (MET-h/day) higher physical activity associated with an adjusted HR of 0.95 (0.91-0.99; p = 0.03). Compared with those without any metabolic risk factors (i.e., obesity, diabetes, gallbladder disease, and physical inactivity), the HRs of acute pancreatitis for those with 1, 2, or ≥3 risk factors were 1.61 (1.47-1.76), 2.36 (2.01-2.78), and 3.41 (2.46-4.72), respectively (p < 0.001). Among men, heavy alcohol drinkers (≥420 g/week) had an HR of 1.52 (1.11-2.09; p = 0.04, compared with abstainers), and current regular smokers had an HR of 1.45 (1.28-1.64; p = 0.02, compared with never smokers). Following a diagnosis of acute pancreatitis, there were higher risks of pancreatic cancer (HR = 8.26 [3.42-19.98]; p < 0.001; 13 pancreatic cancer cases) and death (1.53 [1.17-2.01]; p = 0.002; 89 deaths). Other diseases of the pancreas had similar risk factor profiles and prognosis to acute pancreatitis. The main study limitations are ascertainment of pancreatitis using hospital records and residual confounding. In this relatively lean Chinese population, several modifiable metabolic and lifestyle factors were associated with higher risks of acute pancreatitis, and individuals with acute pancreatitis had higher risks of pancreatic cancer and death.

Although studies are available on the impact of gallbladder disease on the risk of colorectal neoplasia (CRN), the results are still debatable. We conducted a meta-analysis to summarize the correlation between gallbladder diseases and CRN. Eligible studies up to June 2024 were screened and retrieved using PubMed and Web of Science as well as by performing a manual review of references. Subgroup analyses stratified by region, location, and pathology of CRN were performed. Subgroup analyses stratified by classification and size of gallbladder disease were also performed. The pooled odd ratios (ORs) with 95% confidence intervals (CIs) were calculated. Sensitivity analyses were also performed. Begg’s test was conducted to determine the publication bias. A total of twenty studies were included. The results showed that gallbladder disease significantly increased the risk of CRN (OR = 1.20, 95%CI, 1.11–1.29, P  < 0.001). Subgroup analyses showed that subjects with gallstones (OR = 1.14, 95%CI, 1.05–1.25, P  = 0.003) or gallbladder polyps (OR = 1.23, 95%CI, 1.15–1.31, P  < 0.001) had a significantly higher risk of developing CRN. Asians (OR = 1.21, 95%CI, 1.11–1.31, P  < 0.001) with gallstones were more likely to develop CRN. Patients with larger gallbladder polyps (≥ 0.5 cm) were at a greater risk of developing CRN (OR = 1.96, 95%CI, 1.41–2.73, P  < 0.001). Gallbladder polyps and gallstones increase the risk of CRN. Therefore, colonoscopy should be performed in patients with gallbladder disease, especially in those of Asian descent, as well as in people with large gallbladder polyps.

Background Overweight and obese persons are at risk of a number of medical conditions which can lead to further morbidity and mortality. The primary objective of this study is to provide an estimate of the incidence of each co-morbidity related to obesity and overweight using a meta-analysis. Methods A literature search for the twenty co-morbidities identified in a preliminary search was conducted in Medline and Embase (Jan 2007). Studies meeting the inclusion criteria (prospective cohort studies of sufficient size reporting risk estimate based on the incidence of disease) were extracted. Study-specific unadjusted relative risks (RRs) on the log scale comparing overweight with normal and obese with normal were weighted by the inverse of their corresponding variances to obtain a pooled RR with 95% confidence intervals (CI). Results A total of 89 relevant studies were identified. The review found evidence for 18 co-morbidities which met the inclusion criteria. The meta-analysis determined statistically significant associations for overweight with the incidence of type II diabetes, all cancers except esophageal (female), pancreatic and prostate cancer, all cardiovascular diseases (except congestive heart failure), asthma, gallbladder disease, osteoarthritis and chronic back pain. We noted the strongest association between overweight defined by body mass index (BMI) and the incidence of type II diabetes in females (RR = 3.92 (95% CI: 3.10–4.97)). Statistically significant associations with obesity were found with the incidence of type II diabetes, all cancers except esophageal and prostate cancer, all cardiovascular diseases, asthma, gallbladder disease, osteoarthritis and chronic back pain. Obesity defined by BMI was also most strongly associated with the incidence of type II diabetes in females (12.41 (9.03–17.06)). Conclusion Both overweight and obesity are associated with the incidence of multiple co-morbidities including type II diabetes, cancer and cardiovascular diseases. Maintenance of a healthy weight could be important in the prevention of the large disease burden in the future. Further studies are needed to explore the biological mechanisms that link overweight and obesity with these co-morbidities.

Background This study aimed to elucidate the clinical characteristics of occult pancreaticobiliary reflux (OPBR) in benign gallbladder diseases, including gallbladder stone (GS), gallbladder polyp (GP), and gallbladder adenomyomatosis (GA). Methods We studied 578 patients with a normal pancreaticobiliary junction undergoing surgery for gallbladder diseases between December 2020 and January 2022. Of these, 80 patients had elevated bile amylase levels (> 110U/L) and were classified as OPBR patients; 498 comprised the control group. Patients fell into four groups: Group A (GA), Group B (GS alone), Group C (GS and GP), and Group D (GP alone). Results OPBR occurred in 16.2% of GS cases, 7.2% of GP cases, and 20.3% of GA cases. Patients with OPBR were typically older and more likely to have GS but less likely to have GP. In GS patients, OPBR incidence correlated with stone size, peaking at 48% in cases of gallbladder sludge (< 3 mm). OPBR incidence was highest in Group A (20.3%), followed by Group B (16.6%), Group C (8.9%), and Group D (4.8%). Patients over 50 and those in Groups A and B faced higher OPBR risk. In Group A, gallbladder sludge and hyper-gamma-glutamyltransferase were risk factors, while in Group B, gallbladder sludge and age over 50 were risk factors. No specific features associated with OPBR were found in Groups C and D. Conclusion In conclusion, GP isn’t associated with OPBR, irrespective of GS presence. However, in GS alone or GA patients, gallbladder sludge should raise OPBR concerns, necessitating tailored clinical attention.

This study aimed to examine the association between the triglyceride-glucose (TyG) index, TyG-BMI index, and gallbladder disease (GBD) among Uyghurs in the Xinjiang Production and Construction Corps (XPCC), offering insights for GBD prevention and management. A prospective cohort design was utilized, enrolling 12,794 Uyghur participants from XPCC. The cumulative GBD incidence across quartiles of TyG, TyG-BMI, and BMI categories was estimated using the Kaplan-Meier method. The Cox proportional hazard regression model assessed the association between TyG, TyG-BMI, and GBD incidence, while mediation analysis investigated TyG’s potential mediating role in the relationship between BMI and GBD. Participants had a mean age of 37.68 ± 13.96 years, with 51.30% being male. Over a median follow-up of 6.00 years, 466 new GBD cases were identified, yielding a cumulative incidence of 4.3% and an incidence density of 7.68 per 1000 person-years. Women exhibited a higher cumulative incidence of GBD than men. The incidence of GBD gradually rises in both men and women with the increase of age. When the age exceeds 40, the incidence of GBD increases significantly. Following adjustments for gender, age, educational level, exercise frequency, diabetes, HDL-C, and LDL-C levels, individuals in the Q4 TyG index group demonstrated a significantly elevated GBD risk relative to the Q1 group (HR = 1.34, 95% CI:1.01–1.77). Similarly, GBD risk rose progressively across the Q2, Q3, and Q4 TyG-BMI index groups (HR = 1.97, 95% CI:1.23–3.16), (HR = 2.67, 95% CI:1.70–4.19), and (HR = 4.47, 95% CI:2.88–6.93), respectively. Overweight and obesity were also linked to a markedly greater GBD risk compared to normal weight (HR = 1.52, 95% CI:1.09–2.12) and (HR = 3.01, 95% CI:2.22–4.09). Among Uyghurs in the XPCC, elevated TyG and TyG-BMI indices were strongly associated with GBD risk, with TyG-BMI demonstrating the most pronounced association. Early TyG-BMI monitoring may aid in identifying individuals at high risk of developing GBD.

Diabetes has been hypothesized to increase the risk of gallbladder disease based on the observation that obesity and insulin resistance are associated with gallbladder disease. Although several studies have investigated the association between a diabetes diagnosis and risk of gallbladder disease, the results have not been entirely consistent. For this reason we conducted a systematic review and meta-analysis of the available cohort studies. We searched the PubMed and Embase databases for studies of diabetes and gallbladder disease (defined as gallstones, cholecystectomy, or cholecystitis) up to January 9th 2015. Prospective studies were included if they reported relative risk estimates and 95% confidence intervals of gallbladder disease associated with a diabetes diagnosis. Summary relative risks were estimated by use of a random effects model. We identified 10 prospective studies that could be included in the meta-analysis which included 223,651 cases among 7,365,198 participants. The summary RR for diabetes patients was 1.56 (95% CI: 1.26–1.93, I2=99.4%, pheterogeneity<0.0001). The results persisted when stratified by gender, and in most subgroup analyses and there was no heterogeneity among studies with more than 10years duration of follow-up. There was no evidence of publication bias. Our analysis provides further support for an increased risk of gallbladder disease among diabetes patients.

The COVID-19 pandemic possessed far-reaching health implications beyond the public health impact that have yet to be fully elucidated. We hypothesized that the COVID-19 pandemic led to an increase in biliary disease complexity and incidence of emergency cholecystectomy. We reviewed our institutional experience with cholecystectomy from February 2019–February 2021, n = 912. Pre COVID-19 pandemic patients were compared to patients after the onset of the pandemic. Baseline characteristics were compared between groups. A Cochran-Armitage test for trend assessed the temporal impact of COVID-19 on emergency presentation and gallbladder disease complexity. We identified 442 patients pre-pandemic and 470 patients during the pandemic. No significant differences were noted in demographics. COVID-19 significantly impacted emergency presentation (43.2% vs. 56.8%, p= <0.01), cholecystitis (53.2% vs 61.8%; p=<0.01), and gangrenous cholecystitis (2.8% vs 6.1%; p=<0.01). Both groups had similar clinical outcomes. The COVID-19 pandemic affected an increased incidence of emergency presentation and complexity of gallbladder disease but did not significantly impact clinical outcomes. These findings may have broader implications for other diseases possibly affected by COVID-19. •Increased emergent presentation of biliary disease during the COVID-19 pandemic.•Increased chronic and gangrenous cholecystitis and decreased benign disease noted.•No difference in clinical outcomes during the COVID-19 pandemic. [Display omitted]

OBJECTIVE: The objective of this study was to assess the risk of acute pancreatitis in patients with type 2 diabetes compared with that in patients without diabetes. We also examined the risk of biliary disease (defined as occurrence of cholelithiasis, acute cholecystitis, or cholecystectomy), which is a major cause of pancreatitis. RESEARCH DESIGN AND METHODS: We conducted a retrospective cohort study using a large, geographically diverse U.S. health care claims database. Eligible patients (greater-than-or-equal18 years) were enrolled for at least 12 continuous months (1999-2005), with no incident events of pancreatitis or biliary disease during that 1 year baseline period. ICD-9 codes and prescription data were used to identify patients with type 2 diabetes; ICD-9 codes were also used to identify cases of pancreatitis and biliary disease. Overall, 337,067 patients with type 2 diabetes were matched on age and sex with 337,067 patients without diabetes. Incidence rates of disease and 95% CI were calculated per 100,000 person-years of exposure. RESULTS: The type 2 diabetic cohort had a 2.83-fold (95% CI 2.61-3.06) greater risk of pancreatitis and 1.91-fold (1.84-1.99) greater risk of biliary disease compared with the nondiabetic cohort. Relative to patients of corresponding age without diabetes, younger type 2 diabetic patients had the highest risk of pancreatitis (<45 years: incidence rate ratio [IRR] 5.26 [95% CI 4.31-6.42]; greater-than-or-equal45 years: 2.44 [2.23-2.66]). CONCLUSIONS: These data suggest that patients with type 2 diabetes may have an increased risk of acute pancreatitis and biliary disease.

Background Gallbladder disease (GBD) can increase the risk of cardiovascular disease (CVD). However, GBD has rarely been reported in the less developed, rural areas of Xinjiang. This study aimed to determine the prevalence of GBD and incidence of CVD in a prospective cohort study in rural Xinjiang. Moreover, the study aimed to explore the association between GBD and CVD within this cohort. Methods The study cohort included 11,444 Uyghur adults in Xinjiang, 3 rd division, from the 51st Mission. Study groups were classified according to whether GBD was present or absent at baseline. The occurrence of CVD was the end event. Demographic, anthropometric, and biochemical data were recorded, and the incidence of CVD in the GBD and non-GBD groups analysed. Cox proportional hazards regression models were used to assess the association between GBD and CVD and factors associated with their incidence. Several subgroup analyses were performed to assess CVD incidence in different subgroups. The interaction between GBD and cardiometabolic risk factors, and subsequent risk of developing CVD, was evaluated. Results Prevalence of GBD in the study cohort was 10.29%. After a median follow-up of 4.92 years, the cumulative incidence of CVD in the study cohort was 10.49%, 8.43% in males and 12.65% in females. CVD incidence was higher in the GBD group (34.04% vs. 7.78%, HR = 4.96, 95% CI: 4.40–5.59). After multivariate adjustment, the risk of CVD remained higher in the GBD group (HR = 2.89, 95% CI: 2.54–3.29). Subgroup analyses showed male sex, smoking, alcohol consumption, lack of exercise, and abnormal renal function were all associated with increased risk of CVD. Moreover, the risk of CVD was markedly higher in GBD combined with cardiometabolic risk factors (hypertension, T2DM, dyslipidaemia, overweight, and abdominal obesity), than in cardiometabolic risk factors alone and this was higher in the GBD group than in the non-GBD group regardless of whether cardiometabolic risk factors were combined. Conclusion GBD is an important independent risk factor for CVD development. Awareness of these associations will raise concerns among clinicians about the risk of cardiovascular disease in patients with GBD.