Prevalence of Common Risk Factors Between Gallstones and Non-Alcoholic Fatty Diseases in Patients Referred to the Gastroenterology Clinic of Shahid Mostafa Khomeini Hospital, Ilam in 2021

Gallstones are one of the most common problems of the biliary system, the best treatment of which is the traditional surgical removal of the gallbladder. Nonalcoholic fatty liver disease (NAFLD) and gallstone disease (GSD) secondary to the gallbladder are very common health problems worldwide. NAFLD and GSD share several risk factors, including age, ethnicity, and metabolic factors. Therefore, the aim of the present study is to investigate the prevalence of common risk factors between gallstones and non-alcoholic fatty liver disease in patients referred to the gastroenterology clinic of Shahid Mostafa Khomeini Hospital in Ilam.

In this descriptive study, cholecystectomy patients referred to the gastroenterology clinic of Shahid Mostafa Khomeini Hospital in Ilam were studied. The required data were collected by a researcher-made questionnaire with items on age, gender, type of surgery, emergency surgery, ultrasound findings, liver enzymes, BMI and severity of fatty liver. SPSS version 20 software was used for the statistical analysis of the data.

This study included a total of 140 patients with a mean age of 41.12 years, and the majority of them (n=92, 65.7%) were women. The results showed that most of the surgeries performed in patients were of the conversion type, with a frequency of 84 (60%). A total of 55% of the patients did not have fatty liver and 17.1% were categorized in grade I of fatty liver disease, 19.3% were grade II and 8.6% were grade III. The mean alanine aminotransferase (ALT) (P <0.33) and aspartate aminotransferase (AST) (P<0.37) were lower in patients with conversion surgery compared to those who had undergone laparoscopic surgery, but this relationship was not statistically significant. The correlation of fatty liver severity with ALT was significantly positive in a direct way, and that of fatty liver severity with AST and ALP was direct but not significant. The correlation of gender with fatty liver and gallstones was direct but not in a statistically significant way; however, the correlation coefficient between liver enzymes and gallstones was significantly direct and positive. The correlation of BMI with fatty liver was direct, and with gallstones, it was indirect and negative, but not in a statistically significant manner. As BMI increased in patients with fatty liver, its grade also increased.

The results of the present study showed a direct relationship for gender, gallstones in cholecystectomy patients, and ALT with fatty liver, which suggests the higher prevalence of fatty liver in women. The mean ALT and AST were lower in patients with conversion surgery compared to laparoscopic surgery; therefore, it is recommended to conduct the study in a larger group over a longer period of time to achieve more accurate and effective results.