ASSESSMENT OF CLINICAL AND MOLECULAR-GENETIC RISK FACTORS FOR THE DEVELOPMENT OF GALLSTONE DISEASE AND POSTOPERATIVE RECURRENCE OF CHOLELITHIASIS IN PATIENTS WITH OBESITY

Abstract:Gallstone disease is one of the most common disorders of the hepatobiliary system and is closely associated with obesity, insulin resistance, dyslipidemia and disturbances of cholesterol and bile acid metabolism. The purpose of this thesis is to evaluate, based on published scientific literature, the principal clinical and molecular-genetic factors associated with the development of gallstone disease and the recurrence of biliary stones after surgical or endoscopic treatment in patients with obesity. Particular attention is paid to the potential roles of the ADIPOQ and UGT2B15 genes. The work is a narrative literature review and does not contain original experimental or clinical data. Obesity promotes cholesterol supersaturation of bile, gallbladder hypomotility, chronic low-grade inflammation and changes in enterohepatic bile acid circulation. After cholecystectomy, true recurrence of gallbladder stones is anatomically impossible; therefore, postoperative recurrence generally refers to newly formed or recurrent common bile duct or intrahepatic stones after previous complete stone clearance. The ADIPOQ gene may influence lithogenic risk through adiponectin-mediated regulation of insulin sensitivity, lipid oxidation and inflammatory activity. UGT2B15 may be considered a candidate modifier because it participates in hepatic glucuronidation and steroid hormone metabolism. However, a direct association between UGT2B15 variants and gallstone recurrence has not yet been confirmed. Integrated assessment of obesity-related metabolic abnormalities, biliary anatomy and genetic predisposition may improve individual risk stratification and postoperative monitoring.