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 a multifactorial disorder of the hepatobiliary system whose development is associated with metabolic, environmental, anatomical and genetic factors. Obesity is one of the most important modifiable risk factors because it contributes to hepatic cholesterol hypersecretion, cholesterol supersaturation of bile, insulin resistance, dyslipidemia, gallbladder hypomotility and chronic low-grade inflammation. The purpose of this thesis is to analyse the principal clinical and molecular genetic risk factors for the development of gallstone disease and postoperative recurrence of biliary stones in patients with obesity based on published scientific literature. The work is a narrative literature review and contains no original experimental or clinical results. Particular attention is paid to the possible roles of the APOE and UGT2B17 genes. APOE participates in the transport and redistribution of cholesterol and other lipids. Although certain studies have associated the APOE ε4 allele with increased biliary cholesterol and lithogenicity, meta-analyses have not confirmed a stable independent association with gallstone disease. UGT2B17 participates in the glucuronidation of steroid hormones and may influence body weight, androgen metabolism and hepatic metabolic processes. However, its direct association with gallstone formation or postoperative recurrence has not been established. Comprehensive risk assessment should therefore combine anthropometric, metabolic, anatomical, surgical and molecular genetic indicators.