Abstract
IntroductionThe aim of the study was to determine the frequency of gallstones in patients with decompensated cirrhosis and to know about mean Body mass index (BMI) in patients of decompensated cirrhosis i.e End stage liver disease (ESLD) with and without gallstones.Methodsit is a cross sectional descriptive study, conducted at the department of Hepato-gastroenterology, Sindh Institute of Urology and Transplantation (SIUT), Karachi from 1st August 2014 to 28 February 2015. Two hundred patients were enrolled from outpatient clinics of Hepato-gastroenterology that fulfilled the defined selection criteria. Questionnaire was filled for data collection. SPSS version 20.0 was used to analyze data. Mean value of age and BMI was calculated by mean ± S.D. values. Mean ± SD was also calculated for BMI in patients with and without gallstones. Stratification of the age, gender, and liver disease severity were done and chi-Square test was applied. p-values less than 0.05 considered statistically significant.ResultsTwo hundred consecutive patients were enrolled among them 112(56%) were male. Mean age was 46.89 ± 11.9, BMI 23.59 ± 4.7 and CTP score was 9.7 ± 1.9. Most of the patient had Child class 'B' cirrhosis 102(51%), most common etiology was found to be Hepatitis C 133 (66.5%), cholelithiasis was found in 59(29.5%), sludge in 36 (18%) and both stone and sludge in 24(12%) of the cases. Advanced liver disease that is, more CTP score and child class 'C' was associated with increased frequency of gall stone formation (p-value = 0.012), and advancing age on age stratification (p-value = 0.024) however no relation was observed with increase BMI, gender, ethnicity, cause or duration of disease in this population.ConclusionGallstone formation is associated with advanced stage of cirrhosis and hepatitis C Virus related CLD, contrary to the established risk factors, no relation of gender or BMI was found in decompensated liver disease.
Highlights
The aim of the study was to determine the frequency of gallstones in patients with decompensated cirrhosis and to know about mean Body mass index (BMI) in patients of decompensated cirrhosis i.e End stage liver disease (ESLD) with and without gallstones
A study done at Taiwan by Li et al concluded that there's no difference in the mean BMI of patients with gallstones (22.2±0.6) and without gallstones (23.7 ± 0.5) [17] in liver cirrhosis and it included patients of both compensated and decompensated cirrhosis, he concluded that risk of gallstone formation increases with severity of cirrhosis, that is most of the patient having gallstones belongs to child class 'C', in this study sample size was not calculated, so the results cannot be generalized to patients with decompensated cirrhosis
Significant association was found for child Turcotte Pugh (CTP) score and CTP class, i.e. 0.013 and 0.013 respectively while no association of gallstones could be elicited for age, gender, BMI, duration of disease and ethnicity
Summary
The aim of the study was to determine the frequency of gallstones in patients with decompensated cirrhosis and to know about mean Body mass index (BMI) in patients of decompensated cirrhosis i.e End stage liver disease (ESLD) with and without gallstones. Advanced liver disease that is, more CTP score and child class 'C' was associated with increased frequency of gall stone formation (p-value = 0.012), and advancing age on age stratification (p-value = 0.024) no relation was observed with increase BMI, gender, ethnicity, cause or duration of disease in this population. A study done at Taiwan by Li et al concluded that there's no difference in the mean BMI of patients with gallstones (22.2±0.6) and without gallstones (23.7 ± 0.5) [17] in liver cirrhosis and it included patients of both compensated and decompensated cirrhosis, he concluded that risk of gallstone formation increases with severity of cirrhosis, that is most of the patient having gallstones belongs to child class 'C', in this study sample size was not calculated, so the results cannot be generalized to patients with decompensated cirrhosis. The rationale of this study is to assess the frequency of gallstones and Mean BMI in patients with or without gallstones decompensated cirrhosis, in order to ascertain the magnitude of disease, possible relation to BMI
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