Gallbladder disease represents a major health care problem in the United States. Approximately 12% of the U.S. population have gallstones, and more then 700,000 cholecystectomies are performed each year. In recent years an increasing number of cholecystectomies are performed for abnormal gallbladder motility or biliary dyskinesia. Adipokines including leptin and adiponectin are proteins secreted by fat cells. Obesity, diabetes, hyperlipidemia, cardiovascular disease, and cancer have all been associated with high leptin and low adiponectin levels. However, little is known about the role of adipokines in the development of human gallbladder disease. Therefore, we designed a study to determine if adipokines are associated with gallbladder disease.
Methods: 331 healthy adult nondiabetic volunteers were studied. Gallbladder (GB) ultrasounds were performed before and after a standardized fatty meal. A GB ejection fraction (EF) was calculated, and an EF of <26% was considered abnormal. Gallbladder disease was defined as gallstones on ultrasound, previous cholecystectomy, or a GB EF <26%. Body composition was measured by dual-energy x-ray absorptiometry (DXA) scanning. Visceral and subcutaneous fat was estimated by computerized tomography (CT scanning). Serum was analyzed for leptin, adiponectin, insulin, glucose, and lipids.Data is expressed as the mean ± S.E.M. Student's t test and Chi-squared tests were used as appropriate. A p-value <0.05 was considered significant.
Results: The mean age of the study population was 45.6± 1.6 years and, 60% were female. 94 subjects (28%) were found to have gallbladder disease (asymptomatic gallstones 33, previous cholecystectomy 27, abnormal gallbladder motility 34). No differences were observed with respect to serum lipids, glucose, insulin, visceral, and subcutaneous fat measurements in subjects with and without gallbladder disease. Data for adipokines and body fat are shown in the table.
Conclusions: These data suggest that human gallbladder disease is associated with 1) a higher body mass index, 2) a higher percent total body fat, and 3) a higher serum leptin and leptin/ adiponectin ratio. Therefore, we conclude that obesity, percent total body fat, and adipokines may be associated with human gallbladder disease.

GB Disease	N	% Female	BMI (kg/m2)	% body fat	Leptin (ng/ml)	Adiponectin (ng/ml)	Leptin/Adiponectin Ratio
Yes	94	69%*	34.8±1.0†	40.8±1.2†	23.5±1.8†	8.8±0.4	2.6±0.3†
No	237	57%	31.8±0.6	36.9±0.7	16.5±0.8	8.6±0.3	2.0±0.1

* p< 0.05 vs No GB disease, † p< 0.01 vs No GB disease