Clinical features of the comorbid course of non-alcoholic fatty liver disease and gallstone disease

Abstract

Aim. To determine the diagnostic value of clinical features of the comorbid course of non-alcoholic fatty liver disease (NAFLD) and gallstone disease (GD) to improve the effectiveness of patient management. Materials and methods. 183 patients with NAFLD were included into the open comparative study. The main group was represented by patients with NAFLD and GD (n=88), of which 53 patients underwent cholecystectomy (CE). The comparison group was represented by patients with NAFLD without GD (n=95). A standard laboratory and instrumental examinations were performed, including elastometry to assess of the stage of liver fibrosis. Results. There were more women in the main group (2=8.48; p0.01). There were positive correlations between the age of patients and the duration of NAFLD with the presence of GD and CE (rs=0.135; p0.01 and rs=0.168; p0.01 respectively). Patients of the main group had the general weakness and fatigue (2=11.33, rs=0.234; p0.01 and 2=15.68, rs=0.281; p0.01 respectively), as well as a bitter taste in the mouth (2=11.66; p0.01; rs=0.147; p0.01). Coronary heart disease was diagnosed more often among people suffering from NAFLD and GD (25% vs 9.47% in patients of the comparison group, p0.01). Both of NAFLD and GD were associated with the development of type 2 diabetes (rs=0.164; p0.01). Individuals suffering from GD after CE had higher LDL and GGT values (rs=0.228; p0.01 and rs=0.298; p0.01 respectively). The number of people with advanced fibrosis were significantly higher (26.31%) in the GD group, especially among people after CE (30.18%). The stage of liver fibrosis had a positive significant relationship with CE (rs=0.366; p0.01). Conclusion. Patients suffering from GD and NAFLD had a symptom of dyspepsia and general weakness. High prevalence of type 2 diabetes and сoronary heart disease, high level of LDL and GGT were found in patients with GD and after CE. CE in patients suffering from GD and NAFLD was associated with the formation of progressive stages of liver fibrosis.