BACKGROUND Cholecystectomy, central obesity, and insulin resistance (IR) are established risk factors for nonalcoholic fatty liver disease (NAFLD). We aimed to examine the relative contributions and combined association of cholecystectomy and central obesity/IR with NAFLD risk. METHODS We conducted a cross-sectional analysis of data from the third National Health and Nutrition Examination Survey (NHANES III), in which ultrasonography was performed. Odds ratios (ORs) and 95% confidence intervals for NAFLD were estimated using logistic regression. RESULTS Cholecystectomy associated with a higher prevalence of NAFLD compared with gallstones among both centrally obese and non-centrally-obese subjects. Gallstones associated with a higher prevalence of NAFLD only in the presence of central obesity. In centrally obese participants, the OR increased from 2.67 (2.15-3.32) for participants without gallstone disease to 6.73 (4.40-10.29) for participants with cholecystectomy. In participants with cholecystectomy, the OR increased from 2.57 (1.35-4.89) for participants without central obesity to 6.73 (4.40-10.29) for centrally obese counterparts. We observed a modest increase in the risk of NAFLD with cholecystectomy compared with a large increase in the risk with IR or metabolic syndrome. CONCLUSION The magnitude of the NAFLD risk contributed by cholecystectomy was similar to central obesity in combined analyses. The magnitude of the association with IR or metabolic syndrome was greater than with cholecystectomy.

中文翻译：

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与非酒精性脂肪肝疾病风险相关的胆囊切除术与中心性肥胖或胰岛素抵抗的关系：第三次美国国家健康和营养调查。

背景技术胆囊切除术，中枢性肥胖和胰岛素抵抗（IR）是非酒精性脂肪肝疾病（NAFLD）的危险因素。我们的目的是检查胆囊切除术和中心性肥胖/ IR与NAFLD风险的相对贡献以及联合关联。方法我们对第三次全国健康和营养检查调查（NHANES III）的数据进行了横断面分析，在该数据中进行了超声检查。使用逻辑回归估计NAFLD的赔率（OR）和95％置信区间。结果在中心型肥胖和非中心型肥胖患者中，胆囊切除术与胆结石相比，NAFLD患病率更高。胆结石仅在存在中枢性肥胖的情况下与较高的NAFLD患病率相关。在中度肥胖的参与者中，胆囊切除术参与者的OR值从无胆石症参与者的2.67（2.15-3.32）增加到6.73（4.40-10.29）。在进行胆囊切除术的参与者中，OR从无中心性肥胖者的2.57（1.35-4.89）增加到中度肥胖者的6.73（4.40-10.29）。我们观察到与进行IR或代谢综合征的风险大幅度增加相比，进行胆囊切除术的NAFLD风险适度增加。结论在联合分析中，由胆囊切除术引起的NAFLD风险的程度与中枢性肥胖相似。IR或代谢综合征的关联程度大于胆囊切除术。OR从无中枢性肥胖的参与者的2.57（1.35-4.89）增加到中枢性肥胖的参与者的6.73（4.40-10.29）。我们观察到与进行IR或代谢综合征的风险大幅度增加相比，进行胆囊切除术的NAFLD风险适度增加。结论在联合分析中，由胆囊切除术引起的NAFLD风险的程度与中枢性肥胖相似。IR或代谢综合征的关联程度大于胆囊切除术。OR从无中枢性肥胖的参与者的2.57（1.35-4.89）增加到中枢性肥胖的参与者的6.73（4.40-10.29）。我们观察到与进行IR或代谢综合征的风险大幅度增加相比，进行胆囊切除术的NAFLD风险适度增加。结论在联合分析中，由胆囊切除术引起的NAFLD风险的程度与中枢性肥胖相似。IR或代谢综合征的关联程度大于胆囊切除术。结论在联合分析中，由胆囊切除术引起的NAFLD风险的程度与中枢性肥胖相似。IR或代谢综合征的关联程度大于胆囊切除术。结论在联合分析中，由胆囊切除术引起的NAFLD风险的程度与中枢性肥胖相似。IR或代谢综合征的关联程度大于胆囊切除术。