Association of Metabolic Syndrome and Cholelithiasis: Understanding the Underlying Mechanism for Better Treatment

Metabolic syndrome is characterized by a combination of conditions, including abdominal obesity, elevated blood pressure, increased blood sugar levels, and high triglycerides. The incidence of metabolic syndrome is concerningly increasing worldwide. Metabolic syndrome increases the risk of cardiovascular diseases, type 2 diabetes mellitus, non-alcoholic fatty liver disease, chronic kidney disease, and even cancer. Cholelithiasis refers to the formation of gallstones. Metabolic associations, including dyslipidemia, obesity, diabetes, and insulin resistance, are all risk factors for cholelithiasis. Modifiable factors include changes in lifestyle and metabolic conditions. In this narrative review, we searched the PubMed, Scopus, and Google Scholar databases to identify evidence-based literature on the association between metabolic syndrome and cholelithiasis. We discuss the biochemical reaction underlying cholelithiasis, the receptors and signaling pathways involved, and therapeutic options targeting hepatic cholesterol synthesis and secretion. We discuss the molecular mechanisms underlying the association between metabolic syndrome and cholelithiasis, including insulin resistance, genetic factors, and gallbladder functions relevant to cholelithiasis. The clinical implications, along with surgical interventions and treatment, are also discussed in detail. The review may benefit physicians involved in the treatment of cholelithiasis and metabolic syndrome, and help researchers develop appropriate drugs in the future.