Zhihao Yu1, Changlin Yang1, Xuesong Bai2, Guibin Yao3, Xia Qian4, Wei Gao5, Yue Huang6, Xiaodong Tian7, Shi Cheng8, Yamin Zheng9. 1. Department of General Surgery, Xuanwu Hospital, The First Clinical Medical College, Capital Medical University, No.45 Changchun Street, Beijing, China. 2. Vascular Surgery Department, Xuanwu Hospital, The First Clinical Medical College, Capital Medical University, Beijing, China. 3. Department of General Surgery, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China. 4. Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Florida, Gainesville, Florida, USA. 5. Pathology Department, Xuanwu Hospital, The First Clinical Medical College, Capital Medical University, Beijing, China. 6. Information Center of Xuanwu Hospital, Xuanwu Hospital, The First Clinical Medical College, Capital Medical University, Beijing, China. 7. Department of General Surgery, Peking University First Hospital, Beijing, China. 8. Department of General Surgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. 9. Department of General Surgery, Xuanwu Hospital, The First Clinical Medical College, Capital Medical University, No.45 Changchun Street, Beijing, China. cpuzym@sina.com.
Abstract
BACKGROUND: The purpose of this study was to assess the risk factors for cholesterol polyp formation in the gallbladder. METHODS: This was a multicenter retrospective study based on pathology. From January 2016 to December 2019, patients who underwent cholecystectomy and non-polyp participants confirmed by continuous ultrasound follow-ups were reviewed. Patients in the cholesterol polyp group were recruited from three high-volume centers with a diagnosis of pathologically confirmed cholesterol polyps larger than 10 mm. Population characteristics and medical data were collected within 24 h of admission before surgery. The non-polyp group included participants from the hospital physical examination center database. They had at least two ultrasound examinations with an interval longer than 180 days. Data from the final follow-up of the non-polyp group were analyzed. The risk factors for cholesterol polyp formation were analyzed by comparing the two groups. RESULTS: A total of 4714 participants were recruited, including 376 cholesterol polyp patients and 4338 non-polyp participants. In univariate analysis, clinical risk factors for cholesterol polyps were age, male sex, higher body mass index (BMI), higher low-density lipoprotein (LDL), lower high-density lipoprotein (HDL), and higher aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels. In multivariate logistic analysis, independent risk factors were age > 50 years (odds ratio [OR] = 3.02, 95% confidence interval [CI] 2.33-3.91, P < 0.001], LDL > 2.89 mmol/L (OR = 1.38, 95% CI 1.08-1.78, P = 0.011), lower HDL (OR = 1.78 95% CI 1.32-2.44, P < 0.001), AST > 40 IU/L (OR = 3.55, 95% CI 2.07-6.07, P < 0.001), and BMI > 25 kg/m 2 (OR = 1.32, 95% CI 1.01-1.72, P = 0.037). CONCLUSIONS: Age, LDL, HDL, AST, and BMI are strong risk factors for cholesterol polyp formation. Older overweight patients with polyps, accompanied by abnormal lipid levels, are at high risk for cholesterol polyps.
BACKGROUND: The purpose of this study was to assess the risk factors for cholesterol polyp formation in the gallbladder. METHODS: This was a multicenter retrospective study based on pathology. From January 2016 to December 2019, patients who underwent cholecystectomy and non-polyp participants confirmed by continuous ultrasound follow-ups were reviewed. Patients in the cholesterol polyp group were recruited from three high-volume centers with a diagnosis of pathologically confirmed cholesterol polyps larger than 10 mm. Population characteristics and medical data were collected within 24 h of admission before surgery. The non-polyp group included participants from the hospital physical examination center database. They had at least two ultrasound examinations with an interval longer than 180 days. Data from the final follow-up of the non-polyp group were analyzed. The risk factors for cholesterol polyp formation were analyzed by comparing the two groups. RESULTS: A total of 4714 participants were recruited, including 376 cholesterol polyp patients and 4338 non-polyp participants. In univariate analysis, clinical risk factors for cholesterol polyps were age, male sex, higher body mass index (BMI), higher low-density lipoprotein (LDL), lower high-density lipoprotein (HDL), and higher aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels. In multivariate logistic analysis, independent risk factors were age > 50 years (odds ratio [OR] = 3.02, 95% confidence interval [CI] 2.33-3.91, P < 0.001], LDL > 2.89 mmol/L (OR = 1.38, 95% CI 1.08-1.78, P = 0.011), lower HDL (OR = 1.78 95% CI 1.32-2.44, P < 0.001), AST > 40 IU/L (OR = 3.55, 95% CI 2.07-6.07, P < 0.001), and BMI > 25 kg/m 2 (OR = 1.32, 95% CI 1.01-1.72, P = 0.037). CONCLUSIONS: Age, LDL, HDL, AST, and BMI are strong risk factors for cholesterol polyp formation. Older overweight patients with polyps, accompanied by abnormal lipid levels, are at high risk for cholesterol polyps.