Gallbladder disease is associated with insulin resistance in a high risk Hispanic population

Background/Aims We tested whether cholesterol gallstone disease (GS) is associated to insulin resistance and serum C-reactive protein (CRP) in a high risk population. Methods This was a nested case–control study on 881 Chilean subjects that included clinical examination, abdominal ultrasound and blood chemistries. Insulin resistance was determined by the homeostasis model assessment index (IR-HOMA). Results Compared to controls (n = 582), age and sex adjusted median IR-HOMA was significantly elevated in subjects with GS (n = 299) (P < 0.001). Risks of GS in subjects with insulin resistance and different body mass index (BMI) were: BMI < 25, 2.2 (1.1–4.7); BMI 25–30, 1.5 (0.9–2.5) and BMI > 30, 1.7 (1.0–2.9). Risk of GS in subjects with metabolic syndrome was 1.7 (CI, 1.2–2.5) and with fatty liver, 1.5 (1.1–2.2). Risk of GS in subjects with CRP > 1 mg/dL was 1.0 (0.7–1.7). Conclusions GS is associated to insulin resistance, fatty liver and to metabolic syndrome, but not to serum CRP in a high risk Hispanic population. Insulin resistance could have a major role in the pathogenesis of GS favoring the production of cholesterol supersaturated bile and altering gallbladder function.