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| April 1998, Volume 22, Number 4, Pages 294-302 |
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| Paper |
| Fasting gall bladder volume and lithogenicity in relation to glucose tolerance, total and intra-abdominal fat masses in obese non-diabetic subjects |
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| H W Hendel1,2,3,a, L Højgaard1, T Andersen3,6, B H Pedersen4, L I Paloheimo5, J F Rehfeld5, A Gotfredsen2 and M H Rasmussen2 |
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1Department of Clinical Physiology and Nuclear Medicine, Hvidovre Hospital
2Department of Endocrinology, Hvidovre Hospital
3Department of Medical Gastroenterology, Hvidovre Hospital
4Department of Radiotherapy and Ultrasonography, Gentofte County Hospital
5Department of Clinical Biochemistry, Rigshospitalet, University of Copenhagen
6Department of Medicine, Elsinore Hospital, Denmark
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aCorrespondence: Helle W. Hendel, MD, Department of Clinical Physiology and Nuclear Medicine 239, Hvidovre Hospital, Kettegårds Allé 30, DK-2650 Copenhagen, Denmark. |
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| Abstract |
| OBJECTIVE: To investigate whether total body fat mass or fat distribution and associated metabolic disturbances in glucose and lipid metabolism influence the well known gallstone pathogenetic factors in obese subjects in order to explain why some obese subjects develop gallstones and some do not. DESIGN: Cross sectional study of gallstone pathogenetic factors, body composition, fat distribution, glucose and lipid metabolism. SUBJECTS: 57 healthy overweight subjects (aged 26-64 y, body mass index (BMI) 30-45 kg/m2). MEASUREMENTS: Total and intra-abdominal fat masses were measured by dual X-ray absorptiometry and abdominal CT scanning, respectively. The lithogenic index was measured in aspirated bile. The gallbladder volume was determined by ultrasound and the gallbladder ejection fraction% by dynamic cholescintigraphy. Plasma cholecystokinin (CCK) concentrations during a meal were measured with a specific radioimmunoassay. Insulin sensitivity was measured by the Minimal Model and glucose tolerance by an oral glucose tolerance test (OGTT). Serum lipid concentrations were measured by standard methods. RESULTS: The gallbladder volume in the fasting state increased with increasing intra-abdominal fat mass (P=0.006) and was increased in subjects with impaired glucose tolerance (41 vs 27 ml, P=0.001). The lithogenic index was >1 in all subjects and correlated with total fat mass (P=0.04). CONCLUSION: Gallstone pathogenesis in obesity seems to be influenced by the total body fat mass and its regional distribution possibly via mutual association with the glucose tolerance. |
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| Keywords |
| obesity; abdominal fat mass; gallstone; gallbladder; lithogenicity; glucose tolerance |
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| Received 17 July 1997; revised 14 November 1997; accepted 21 November 1997 |
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| April 1998, Volume 22, Number 4, Pages 294-302 |
| Table of contents Previous Abstract Next Article PDF |
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