Journal of Health and Medical Sciences

ISSN 2622-7258

Published: 04 February 2019

Sonographic Association between Fatty Liver and Gall Bladder Stones among all Adult Patients Visiting Private Clinics of Lahore City

Muhammad Omer Abdullah, Raham Bacha, Muhammad Waseem, Kaleem Ullah, Adnan Ashraf, Daniyal, Muhammad Yousaf Farooq, Muhammad Fiaz

The University of Lahore, Pakistan

pdf download

Download Full-Text Pdf



Background: Fatty liver (chronic liver disease) was most commonly found associated with gall stones. It occurs due to the accumulation of lipid in hepatocytes mainly triglyceride. Due to a high incidence of obesity in the population, the risk of fatty liver and gall stones also increases. In Pakistani population, its prevalence of fatty liver was 10 - 14 %. Fatty liver and gall stones could easily be observed on ultrasound. Objective: To determine the association of fatty liver with gall stones in the patients younger than 50 years. Methods: This Cross-sectional descriptive study was conducted at Park view diagnostic center, Sharif Medical City Hospital, and Central Park Hospital. All the adult patients younger than 50 years diagnosed with gall stones were included. Ultrasound machine Toshiba Xario XG was used to perform this research to determine the association of fatty liver with gallbladder stones in the patient younger than 50 years. Fatty liver disease and gall stones were diagnosed on a trans-Abdominal scan by using a curved array transducer of 2.5 to 5MHz frequency. Results: Total 138 patients diagnosed with gall bladder stones were included, among them fatty liver disease was found in 95(68.8%) patients in which most of them were females. The individuals of 36-50 years were mainly involved while under the age of 30 years were rarely involved in gall bladder stones as well as fatty liver. Conclusions: We observed that gall stones are associated with fatty liver disease. Moreover, fatty liver disease was more common in females than males.


  1. Browning JD, Horton JD. Molecular mediators of hepatic steatosis and liver injury. The Journal of clinical investigation. 2004 Jul 15;114(2):147-52.

  2. Koller T, Kollerova J, Hlavaty T, Huorka M, Payer J. Cholelithiasis and markers of nonalcoholic fatty liver disease in patients with metabolic risk factors. Scandinavian journal of gastroenterology. 2012 Feb 1;47(2):197-203.

  3. Reddy JK, Rao MS (May 2006). "Lipid metabolism and liver inflammation. II. Fatty liver disease and fatty acid oxidation". American Journal of Physiology. Gastrointestinal and Liver Physiology. 290 (5): G852–8

  4. Wong VW, Adams LA, de Lédinghen V, Wong GL, Sookoian S (August 2018). "Noninvasive biomarkers in NAFLD and NASH - current progress and future promise." Nature Reviews. Gastroenterology & Hepatology. 15 (8): 461–478

  5. Adams LA, Lymp JF, St Sauver J, Sanderson SO, Lindor KD, Feldstein A, Angulo P (July 2005). "The natural history of nonalcoholic fatty liver disease: a population-based cohort study." Gastroenterology. 129(1): 113–21.

  6. Crabb DW, Galli A, Fischer M, You M (August 2004). "Molecular mechanisms of alcoholic fatty liver: role of peroxisome proliferator-activated receptor alpha." Alcohol. 34 (1): 35–8.

  7. Chalasani, Naga; Younossi, Zobair; Lavine, Joel E.; Charlton, Michael; Cusi, Kenneth; Rinella, Mary; Harrison, Stephen A.; Brunt, Elizabeth M.; Sanyal, Arun J. (January 2018). "The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases." Hepatology. 67 (1): 328–357. 

  8. European Association for the Study of the Liver (EASL); European Association for the Study of Diabetes (EASD); European Association for the Study of Obesity (EASO) (June 2016). "EASL-EASD-EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease." Journal of Hepatology. 64(6): 1388–402.

  9. Ser D, Ryan M (July 2013). "Fatty liver disease--a practical guide for GPs." Australian Family Physician. 42 (7): 444–7

  10. Rinella ME (June 2015). "Nonalcoholic fatty liver disease: a systematic review." JAMA (Systematic review). 313 (22): 2263–73. 

  11. Younossi Z, Anstee QM, Marietti M, Hardy T, Henry L, Eslam M, George J, Bugianesi E (January 2018). "Global burden of NAFLD and NASH: trends, predictions, risk factors, and prevention." Nature Reviews. Gastroenterology & Hepatology. 15 (1): 11–20.

  12. Venkatesh SK, Hennedige T, Johnson GB, Hough DM, Fletcher JG. Imaging patterns and focal lesions in fatty liver: a pictorial review. Abdominal Radiology. 2017 May 1;42(5):1374-92.

  13. Graif M, Yanuka M, Baraz M, Blank A, Moshkovitz M, Kessler A, Gilat T, Weiss J, Walach E, Amazeen P, Irving CS. Quantitative estimation of attenuation in ultrasound video images: correlation with histology in diffuse liver disease. Invest Radiol 2000; 35: 319-24

  14. Nascimbeni F, Pais R, Bellentani S, et al. From NAFLD in clinical practice to answers from guidelines. J Hepatol 2013; 59(4):859-71

  15. De Santis A, Attili AF, Ginanni Corradini S, Scafato E, Cantagalli A, et al. (1997) Gallstones and diabetes: a case-control study in a free-living population sample. Hepatology 25: 787–790.

  16. Diehl AK (2000) Cholelithiasis and the insulin resistance syndrome. Hepatology 31: 528–530.

  17. Ruhl CE, Everhart JE (2000) Association of diabetes, serum insulin, and C-peptide with gallbladder disease. Hepatology 31: 299–303

  18. Qiao T, Ma RH, Luo XB, Yang LQ, Luo ZL, Zheng PM. The systematic classification of gallbladder stones. Plos one. 2013 Oct 4;8(10):e74887.

  19. Ahmed MH, Ali A. Nonalcoholic fatty liver disease and cholesterol gallstones: which comes first? Scandinavian journal of gastroenterology. 2014 May 1;49(5):521-7.

  20. Qin JJ, Ding WJ. Nonalcoholic fatty liver disease and its relevant factors increased the risk of gallstone disease: a systematic review and meta-analysis. Int J Clin Exp Med. 2016 Jan 1;9(2):3009-16

  21. Lonardo A, Lombardini S, Scaglioni F, Ballestri S, Verrone AM, Bertolotti M, Carulli L, Ganazzi D, Carulli N, Loria P. Fatty liver, carotid disease, and gallstones: a study of age-related associations. World journal of gastroenterology: WJG. 2006 Sep 28;12(36):5826

About Us

The Asian Institute of Research is an online and open-access platform to publish recent research and articles of scholars worldwide. Founded in 2018 and based in Indonesia, the Institute serves as a platform for academics, educators, scholars, and students from Asia and around the world, to connect with one another. The Institute disseminates research that is proven or predicted to be of significant influence for the general public.

Contact Us

Please send all inquiries to the email:

Business Address:

5th Floor, Kavling 507, Fajar Graha Pena Tower, Jl. Urip Sumohardjo No.20, Makassar, Indonesia 90234

Copyright © 2018 The Asian Institute of Research. All rights reserved

Stay Connected

  • Instagram - Black Circle
  • Facebook - Black Circle
  • LinkedIn - Black Circle