Insulin Resistance Causes Human Gallbladder Dysmotility

Attila Nakeeb, Anthony G. Comuzzie, Hayder Al-Azzawi, Gabriele E. Sonnenberg, Ahmed H. Kissebah, Henry A. Pitt

Research output: Contribution to journalArticle

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Abstract

Obesity, diabetes, and hyperlipidemia are known risk factors for the development of gallstones. A growing body of animal and human data has correlated insulin resistance with organ dysfunction. The relationship among obesity, diabetes, hyperlipidemia, and abnormal gallbladder motility remains unclear. Therefore, we designed a study to investigate the association among obesity, insulin resistance, hyperlipidemia, and gallbladder dysmotility. One hundred ninety-two healthy adult nondiabetic volunteers were studied. Gallbladder ultrasounds were performed before and after a standardized fatty meal. A gallbladder ejection fraction (EF) was calculated, and an EF of <25% was considered abnormal. Serum was analyzed for cholesterol, triglycerides, cholecystokinin, leptin, glucose, and insulin. The homeostasis assessment model (HOMA) was used to determine insulin resistance. The volunteers had a mean age of 38 years (range, 18-77), and 55% were female. Thirty subjects (15%) had gallstones and were excluded from the study. Thirty subjects (19%) had abnormal gallbladder motility (EF <25%). In lean subjects (n = 96) fasting glucose was significantly increased in the 16 subjects with gallbladder EF <25% versus the 80 subjects with gallbladder EF >25% (109 ± 20 mg/dl versus 78 ± 2 mg/dl, P < 0.05). Similarly, the HOMA index was significantly greater in subjects with gallbladder EF <25% versus gallbladder EF >25% (3.3 ± 1.2 versus 2.0 ± 0.2, P < 0.05). In obese subjects (n = 66), fasting glucose, insulin, and insulin resistance were not associated with a gallbladder EF <25%. These data suggest that in lean, nondiabetic volunteers without gallstones, gallbladder dysmotility is associated with an elevated fasting glucose as well as a high index of insulin resistance. We conclude that insulin resistance alone may be responsible for gallbladder dysmotility that may result in acalculous cholecystitis or gallstone formation.

Original languageEnglish
Pages (from-to)940-949
Number of pages10
JournalJournal of Gastrointestinal Surgery
Volume10
Issue number7
DOIs
StatePublished - Jul 2006

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Gallbladder
Insulin Resistance
Gallstones
Hyperlipidemias
Obesity
Volunteers
Fasting
Acalculous Cholecystitis
Glucose
Human Body
Meals
Insulin

Keywords

  • gallbladder motility
  • Insulin resistance
  • obesity

ASJC Scopus subject areas

  • Surgery

Cite this

Nakeeb, A., Comuzzie, A. G., Al-Azzawi, H., Sonnenberg, G. E., Kissebah, A. H., & Pitt, H. A. (2006). Insulin Resistance Causes Human Gallbladder Dysmotility. Journal of Gastrointestinal Surgery, 10(7), 940-949. https://doi.org/10.1016/j.gassur.2006.04.005

Insulin Resistance Causes Human Gallbladder Dysmotility. / Nakeeb, Attila; Comuzzie, Anthony G.; Al-Azzawi, Hayder; Sonnenberg, Gabriele E.; Kissebah, Ahmed H.; Pitt, Henry A.

In: Journal of Gastrointestinal Surgery, Vol. 10, No. 7, 07.2006, p. 940-949.

Research output: Contribution to journalArticle

Nakeeb, A, Comuzzie, AG, Al-Azzawi, H, Sonnenberg, GE, Kissebah, AH & Pitt, HA 2006, 'Insulin Resistance Causes Human Gallbladder Dysmotility', Journal of Gastrointestinal Surgery, vol. 10, no. 7, pp. 940-949. https://doi.org/10.1016/j.gassur.2006.04.005
Nakeeb, Attila ; Comuzzie, Anthony G. ; Al-Azzawi, Hayder ; Sonnenberg, Gabriele E. ; Kissebah, Ahmed H. ; Pitt, Henry A. / Insulin Resistance Causes Human Gallbladder Dysmotility. In: Journal of Gastrointestinal Surgery. 2006 ; Vol. 10, No. 7. pp. 940-949.
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