Effect of metabolic syndrome components on the risk of malignancy in patients with gallbladder lesions

Abstract Background and AimsThe malignant potential of gallbladder lesions is debated, and there is limited guidance on surveillance. Predicting their risk of malignancy could help clinicians manage and potentially improve prognosis. We evaluated the independent and joint effects of metabolic syndrome components on the risk of malignancy among patients with gallbladder lesions. MethodsUsing a multicenter database, consecutive patients with pathologically confirmed gallbladder lesions between 2012 and 2019 were identified. Univariate and multivariate logistic regression analyses were used to evaluate the effects of metabolic syndrome components (diabetes, hypertension, dyslipidemia, obesity) as additive or combined indicators for the risk of malignancy. Unadjusted and adjusted odds ratios were calculated. ResultsOf the 625 patients, 567 patients were identified with benign gallbladder lesions and 58 patients with gallbladder cancer (GBC). Among all metabolic syndrome components, the proportion of GBC patients with dyslipidemia (63.8%) was significantly greater than benign gallbladder polyps (42.2%, P = 0.002). In multivariate logistic regression analysis, dyslipidemia was associated with a 2.67-fold increase in the risk of GBC (95% confidence interval 1.17-6.09). Dyslipidemia is an independent risk factor for malignancy (adjusted odds ratio 2.164, 95% confidence interval 1.165-4.021), regardless of whether the other risk factors and metabolic syndrome components are combined. Dyslipidemia (adjusted odds ratio 2.164, 95% confidence interval 1.165-4.021) and decreased high-density lipoprotein (HDL, adjusted odds ratio 3.035, 95% confidence interval 1.645-5.600) were closely associated with increased risk of malignancy. ConclusionsDyslipidemia is associated with a 2.67-fold increase in the risk of malignancy, regardless of the presence of other metabolic syndrome components. Dyslipidemia is an independent risk factor for malignancy in patients with gallbladder lesions.