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Clinical guidelines for the prevention of cholelithiasis in high-risk patients treated with GLP-1 receptor agonists

Czech version

Authors: Anna Török Zapletalová 1,2;  Emil Martinka 1;  Peter Galajda 2
Authors‘ workplace: Diabetologické oddelenie NEDÚ, n. o., Ľubochňa 1;  I. interná klinika JLF UK a UNM, Martin 2
Published in: Forum Diab 2026; 15(1): 61-69
Category: Review Article

Overview

Background: The prevalence of type 2 diabetes mellitus and obesity is continuously increasing worldwide as well as in Slovakia. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) represent key therapeutic agents in the management of diabetes and obesity, with well-documented metabolic, cardiovascular, and renal benefits. Despite their favorable clinical profile, GLP-1 RAs are associated with an increased risk of biliary tract diseases, particularly cholelithiasis and cholecystitis. This risk rises with higher doses, longer duration of therapy, and rapid weight loss. Aim: The aim of this paper is to summarize clinical strategies for the prevention of cholelithiasis in patients treated with GLP-1 RAs, with a focus on risk stratification, lifestyle interventions, clinical monitoring, and pharmacological prophylaxis. Methods and Content: This review is based on data from randomized controlled trials, meta-analyses, and international clinical guidelines (EASL, ADA/EASD). It outlines the pathophysiological mechanisms of gallstone formation, key risk factors (demographic, metabolic, pharmacological, and lifestyle-related), and specific aspects of GLP-1 RA–associated cholelithiasis. A practical clinical approach is proposed, including baseline risk stratification, patient education, dietary and physical activity recommendations, regular clinical and imaging follow-up, and consideration of prophylactic ursodeoxycholic acid (UDCA) therapy in high-risk patients. Conclusion: An individualized management strategy for patients treated with GLP-1 RAs, based on early risk identification, structured patient education, controlled weight loss, and targeted UDCA prophylaxis, may significantly reduce the incidence of cholelithiasis and its complications. A multidisciplinary approach is essential to maximize the benefits of GLP-1 RA therapy while minimizing associated biliary adverse events.

Keywords:

obesity – prevention – Cholelithiasis – type 2 diabetes mellitus – GLP-1 receptor agonists – ursodeoxycholic acid

Sources
  1. IDF Diabetes Atlas 2025. 11th ed. Dostupné z WWW: <https://diabetesatlas.org/resources/idf-diabetes-atlas-2025/>.
  2. Nových prípadov cukrovky medziročne ubudlo, najviac pacientov je medzi seniormi. Dostupné z WWW: <https://www.nczisk.sk/Aktuality/Pages/Novych-pripadov-cukrovky-medzirocne-ubudlo-najviac-pacientov-je-medzi-seniormi.aspx>.
  3. Parums DV. Editorial: Global Obesity Rates Continue to Rise with Challenges for New Drug Treatments Including GLP-1 Receptor Agonists. Med Sci Monit 2025; 31: e950816. Dostupné z DOI: <http://dx.doi.org/10.12659/MSM.950816>.
  4. [Morgan S. Research Insights]. The Exponential Growth of Obesity Drugs. The global market for weight-loss medications could reach $150 billion by 2035. May 9, 2025. Dostupné z WWW: <https://www.morganstanley.com/insights/articles/weight-loss-medication-market-unstoppable-growth>.
  5. Wilding JP, Batterham RL, Calanna S et al. [STEP 1 Study Group]. Once-weekly semaglutide in adults with overweight or obesity. N Engl J Med 2021; 384(11): 989–1002. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa2032183>.
  6. Melson E, Ashraf U, Papamargaritis D et al. What is the pipeline for future medications for obesity? Int J Obes (Lond) 2025; 49(3): 433–451. Dostupné z DOI: <http://dx.doi.org/10.1038/s41366–024–01473-y>.
  7. Filippatos TD, Panagiotopoulou TV, Elisaf MS. Adverse effects of GLP-1 receptor agonists. Rev Diabet Stud 2014; 11(3–4): 202–230. Dostupné z DOI: <http://dx.doi.org/10.1900/RDS.2014.11.202>.
  8. Everhart JE, Ruhl CE. Burden of digestive diseases in the United States. Part III: Liver, biliary tract, and pancreas. Gastroenterology 2009; 136(4): 1134–1144. Dostupné z DOI: <http://dx.doi.org/10.1053/j.gastro.2009.02.038>.
  9. Elmehdawi R, Elmajberi S, Behieh A et al. Prevalence of Gall Bladder Stones among Type 2 Diabetic Patients in Benghazi Libya: A Case-control Study. Libyan J Med 2009; 4(1): 27–30. Dostupné z DOI: <http://doi: 10.4176/081122>.
  10. Baddam A, Akuma O, Raj R et al. Analysis of Risk Factors for Cholelithiasis: A Single-Center Retrospective Study. Cureus 2023; 15(9): e46155. Dostupné z DOI: <http://doi:10.7759/cureus.46155>.
  11. Portincasa P, Ciaula AD, Bonfrate L et al. Therapy of gallstone disease: what it was, what it is, what it will be. World J Gastrointest Pharmacol Ther 2012; 3(2): 7–20. Dostupné z DOI: <http://dx.doi.org/10.4292/wjgpt.v3.i2.7>.
  12. Tanaja J, Lopez RA, Meer JM. Cholelithiasis (Archived). In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025. Dostupné z WWW: <https://www.ncbi.nlm.nih.gov/books/NBK470440/>.
  13. Parra-Landazury NM, Cordova-Gallardo J, Méndez-Sánchez N. Obesity and gallstones. Visc Med 2021; 37(5): 394–402. Dostupné z DOI: <http://dx.doi.org/10.1159/000515545>.
  14. Aune D, Norat T, Vatten LJ. Body mass index, abdominal fatness and the risk of gallbladder disease. Eur J Epidemiol 2015; 30(9): 1009–1019. Dostupné z DOI: <http://dx.doi.org/10.1007/s10654–015–0081-y>.
  15. Chung AY, Duke MC. Acute Biliary Disease. Surg Clin North Am 2018; 98(5): 877–894.Dostupné z DOI: <http://dx.doi.org/10.1016/j.suc.2018.05.003>.
  16. Lammert F, Gurusamy K, Ko CW et al. Gallstones Nat Rev Dis Primers 2016; 2 : 16024. Dostupné z DOI: <http://dx.doi.org/10.1038/nrdp.2016.24>.
  17. Bennion LJ, Mott DM, Howard BV. Oral contraceptives raise the cholesterol saturation of bile by increasing biliary cholesterol secretion. Metabolism 1980; 29(1): 18–22. Dostupné z DOI: <http://dx.doi.org/10.1016/0026–0495(80)90092-x>.
  18. Wang DQ-H. Aging per se is an independent risk factor for cholesterol gallstone formation in gallstone susceptible mice. J Lipid Res 2002; 43(1): 1950–1959. Dostupné z DOI:<http://dx.doi.org/10.1194/jlr.m200078-jlr200>.
  19. Pacchioni M, Nicoletti C, Caminiti M et al. Association of obesity and type II diabetes mellitus as a risk factor for gallstones. Dig Dis Sci 2000; 45(10): 2002–2006. Dostupné z DOI: <http://doi:10.1023/a:1005544009372>.
  20. Parra-Landazury NM, Cordova-Gallardo J, Méndez-Sánchez N. Obesity and gallstones. Visc Med 2021; 37(5): 394–402. Dostupné z DOI: <http://dx.doi.org/10.1159/000515545>.
  21. Tsai CJ, Leitzmann MF, Willett WC et al. Central adiposity, regional fat distribution, and the risk of cholecystectomy in women. Gut 2006; 55(5): 708–714. Dostupné z DOI: <http://dx.doi.org/10.1136/gut.2005.076133>.
  22. Völzke H, Baumeister SE, Alte D et al. Independent risk factors for gallstone formation in a region with high cholelithiasis prevalence. Digestion 2005; 71(2): 97–105. Dostupné z DOI: <http://dx.doi.org/10.1159/000084525>.
  23. Chen CH, Lin CL, Hsu CY et al. Association between type I and II diabetes with gallbladder stone disease. Front Endocrinol 2018; 9 : 720. Dostupné z DOI: <http://dx.doi.org/10.3389/fendo.2018.00720>.
  24. Lu Y, Hu L, Song J et al. Gallstone disease and nonalcoholic fatty liver disease in patients with type 2 diabetes: a cross-sectional study. BMC Endocr Disord 2021; 21(1): 231. Dostupné z DOI: <http://dx.doi.org/10.1186/s12902–021–00899-z>.
  25. Liu T, Siyin ST, Yao N et al. Relationship between high-sensitivity C reactive protein and the risk of gallstone disease: results from the Kailuan cohort study. BMJ Open 2020; 10(9): e035880. Dostupné z DOI: <http://dx.doi.org/10.1136/bmjopen-2019–035880>.
  26. Cuevas A, Miquel JF, Reyes MS et al. Diet as a risk factor for cholesterol gallstone disease. J Am Coll Nutr 2004; 23(3): 187–196. Dostupné z DOI: <http://dx.doi.org/10.1080/07315724.2004.10719360>.
  27. Tehrani AN, Saadati S, Yari Z et al. Dietary fiber intake and risk of gallstone: a case–control study. BMC Gastroenterol 2023; 23(1): 119. Dostupné z DOI: <http://dx.doi.org/10.1186/s12876–023–02752–0>.
  28. Johansson K, Sundstrom J, Marcus C et al. Risk of symptomatic gallstones and cholecystectomy after a very-low-calorie diet or low-calorie diet in a commercial weight loss program: 1-year matched cohort study. Int J Obes 2014; 38(2): 279–284. Dostupné z DOI: <http://dx.doi.org/10.1038/ijo.2013.83>.
  29. Liu Z, Liu S, Song P et al. Mendelian randomization study on the causal relationship between food and cholelithiasis. Front Nutr 2024; 11 : 1276497. Dostupné z DOI: <http://dx.doi.org/10.3389/fnut.2024.1276497>.
  30. Tsai CJ, Leitzmann MF, Willett WC et. Long-term intake of dietary fiber and decreased risk of cholecystectomy in women. Am J Gastroenterol 2004; 99(7): 1364–1370. Dostupné z DOI: <http://dx.doi.org/10.1111/j.1572–0241.2004.30153.x>.
  31. Shephard RJ. Physical activity and the biliary tract in health and disease. Sports Med 2015; 45(9): 1295–1309. Dostupné z DOI: <http://dx.doi.org/10.1007/s40279–015–0346–3>.
  32. Kim HJ, Kang TU, Kim MJ et al. Long-term weight patterns and physical activity in gallstones. Sci Rep 2024; 14(1): 25817. Dostupné z DOI: <http://dx.doi.org/10.1038/s41598–024–77218–8>.
  33. Altieri MS, Yang J, Nie L et al. Incidence of cholecystectomy after bar –⁠ iatric surgery. Surg Obes Relat Dis 2018; 14(7): 992–996. Dostupné z DOI: <http://dx.doi.org/10.1016/j.soard.2018.03.028>.
  34. Shiffman ML, Sugerman HJ, Kellum JH et al. Gallstones in patients with morbid obesity. Relationship to body weight, weight loss and gallbladder bile cholesterol solubility. Int J Obes Relat Metab Disord 1993; 17(3): 153–158.
  35. Weinsier RL, Wilson LJ, Lee J. Medically safe rate of weight loss for the treatment of obesity: a guideline based on risk of gallstone formation. Am J Med 1995; 98(2): 115–117. Dostupné z DOI: <http://dx.doi.org/10.1016/S0002–9343(99)80394–5>.
  36. Ortega RM, Fernandez-Azuela M, Encinas-Sotillos A et al. Differences in diet and food habits between patients with gallstones and controls. J Am Coll Nutr 1997; 16(1): 88–95. Dostupné z DOI: <http://dx.doi.org/10.1080/07315724.1997.10718655>.
  37. Syngal S, Coakley EH, Willett WC et al. Long-term weight patterns and risk for cholecystectomy in women. Ann Intern Med 1999; 130(6): 471–477. Dostupné z DOI: <http://dx.doi.org/10.7326/0003–4819–130–6–199903160–00003>.
  38. Costa CJ, Nguyen MTT, Vaziri H et al. Genetics of gallstone disease and their clinical significance: a narrative review. J Clin Transl Hepatol 2024; 12(3): 316–326. Dostupné z DOI: <http://dx.doi.org/10.14218/JCTH.2023.00563>.
  39. Rebholz C, Krawczyk M, Lammert F. Genetics of gallstone disease. Eur J Clin Invest 2018; 48(7): e12935. Dostupné z DOI: <http://dx.doi.org/10.1111/eci.12935>.
  40. Wadden TA, Bailey TS, Billings LK et al. [STEP 3 Investigators]. Effect of subcutaneous semaglutide vs placebo as an adjunct to intensive behavioral therapy on body weight in adults with overweight or obesity: the STEP 3 randomized clinical trial. JAMA 2021; 325(14): 1403–1413. Dostupné z DOI: <http://dx.doi.org/10.1001/jama.2021.1831>.
  41. Nauck MA, Muus Ghorbani ML, Kreiner E et al. [LEADER Publication Committee on behalf of the LEADER Trial Investigators]. Effects of liraglutide compared with placebo on events of acute gallbladder or biliary disease in patients with type 2 diabetes at high risk for cardiovascular events in the LEADER randomized trial. Diabetes Care 2019; 42(10): 1912–1920. Dostupné z DOI: <http://dx.doi.org/10.2337/dc19–0415>.
  42. He L, Wang J, Ping F et al. Association of glucagon-like peptide-1 receptor agonist use with risk of gallbladder and biliary diseases: a systematic review and meta-analysis of randomized clinical trials. JAMA Intern Med 2022; 182(5): 513–519. Dostupné z DOI: <http://dx.doi.org/10.1001/jamainternmed.2022.0338>.
  43. Rehfeld JF, Knop FK, Asmar A et al. Cholecystokinin secretion is suppressed by glucagon-like peptide-1: clue to the mechanism of the adverse gallbladder events of GLP-1-derived drugs. Scand J Gastroenterol 2018; 53(12): 1429–1432. Dostupné z DOI:<http://dx.doi.org/10.1080/00365521.2018.1530297>.
  44. Kalra S. Choosing appropriate glucagon-like peptide 1 receptor agonists: a patient-centered approach. Diabetes Ther 2014; 5(1): 333–340. Dostupné z DOI: <http://dx.doi.org/10.1007/s13300–014–0058-y>.
  45. Sun H, Warren J, Yip J et al. Factors influencing gallstone formation: a review of the literature. Biomolecules 2022; 12(4): 550. Biomolecules 2022; 12(4): 550. Dostupné z DOI:<http://dx.doi.org/10.3390/biom12040550>.
  46. Rehfeld JF, Knop FK, Asmar M. Gastrin secretion in normal subjects and diabetes patients is inhibited by glucagon-like peptide 1: a role in the gastric side effects of GLP-1-derived drugs? Scand J Gastroenterol 2019; 54(12): 1448–1451. Dostupné z DOI: <http://dx.doi.org/10.1080/00365521.2019.1690673>.
  47. [European Association for the Study of the Liver (EASL)]. EASL Clinical Practice Guidelines on the prevention, diagnosis and treatment of gallstones. J Hepatol 2016; 65(1): 146–181. Dostupné z DOI: <http://dx.doi.org/10.1016/j.jhep.2016.03.005>.
  48. Ghusn W, Hurtado MD. Glucagon-like receptor-1 agonists for obesity: weight loss outcomes, tolerability, side effects, and risks. Obes Pillars 2024; 12 : 100127. Dostupné z DOI: <http://dx.doi.org/10.1016/j.obpill.2024.100127>.
  49. Malik VS, Schulze MB, Hu FB. Intake of sugar-sweetened beverages and weight gain: a systematic review. Am J Clin Nutr 2006; 84(2): 274–88.Dostupné z DOI: <http://dx.doi.org/10.1093/ajcn/84.1.274>.
  50. Tsai CJ, Leitzmann MF, Willett WC et al. The effect of longterm intake of cis unsaturated fats on the risk for gallstone disease in men: a prospective cohort study. Ann Intern Med 2004; 141(7): 514–522. Dostupné z DOI: <http://dx.doi.org/10.7326/0003–4819–141–7–200410050–00007>.
  51. Ginter E. Cholesterol: vitamin C controls its transformation to bile acids. Science 1973; 179(4074): 702–704. Dostupné z DOI: <http://dx.doi.org/10.1126/science.179.4074.702>.
  52. Gustafsson U, Wang FH, Axelson M et al. The effect of vitamin C in high doses on plasma and biliary lipid composition in patients with cholesterol gallstones: prolongation of the nucleation time. Eur J Clin Invest 1997; 27(5): 387–391. Dostupné z DOI: <http://dx.doi.org/10.1046/j.1365–2362.1997.1240670.x>.
  53. Walcher T, Haenle MM, Mason RA et al. The effect of alcohol, tobacco and caffeine consumption and vegetarian diet on gallstone prevalence. Eur J Gastroenterol Hepatol 2010; 22(11): 1345–1351. Dostupné z DOI: <http://dx.doi.org/10.1097/MEG.0b013e32833efdb2>.
  54. Berr F, Holl J, Jüngst D et al. Dietary N-3 polyunsaturated fatty acids decrease biliary cholesterol saturation in gallstone disease. Hepatology 1992; 16(4): 960–967. Dostupné z DOI: <http://dx.doi.org/10.1002/hep.1840160418>.
  55. Jonkers IJ, Smelt AH, Ledeboer M et al. Gall bladder dysmotility: a risk factor for gall stone formation in hypertriglyceridaemia and reversal on triglyceride lowering therapy by bezafibrate and fish oil. Gut 2003; 52(1): 109–115. Dostupné z DOI: <http://dx.doi.org/10.1136/gut.52.1.109>.
  56. Attili AF, Scafato E, Marchioli R et al. Festi D. Diet and gallstones in Italy: the cross-sectional MICOL results. Hepatology 1998; 27(6): 1492–1498. Dostupné z DOI: <http://dx.doi.org/10.1002/hep.510270605>.
  57. Philipp E, Wilckens T, Friess E et al. Cholecystokinin, gastrin and stress hormone responses in marathon runners. Peptides 1992; 13(1): 125–128. <http://dx.doi.org/10.1016/0196–9781(92)90150–2>.
  58. Banim PJ, Luben RN, Wareham NJ. Physical activity reduces the risk of symptomatic gallstones: a prospective cohort study. Eur J Gastroenterol Hepatol 2010; 22(8): 983–988. Dostupné z DOI: <http://dx.doi.org/10.1097/MEG.0b013e32833732c3>.
  59. Ramírez-Mejía MM, Ponciano-Rodriguez G, Eslam M et al. GLP-1 receptor agonists and gallbladder disease risk: insights into molecular mechanisms and clinical implications. Ther Adv Endocrinol Metab 2025; 16 : 20420188251406456. Dostupné z DOI: <http://doi:10.1177/20420188251406456>.
  60. Fromm H. Gallstone dissolution therapy. Current status and future prospects. Gastroenterology 1986; 91(6): 1560–1567.
  61. Tao C, Zhang Y, Wan T et al. Glucagon-like peptide-1 receptor agonist-induced cholecystitis and cholelithiasis: a real-world pharmacovigilance analysis using the FAERS database. Front Pharmacol 2025; 16 : 1557691. Dostupné z DOI: <http://doi:10.3389/fphar.2025.1557691>.
  62. Davies MJ, Aroda VR, Collins BS et al. Management of Hyperglycemia in Type 2 Diabetes, 2022. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care 2022; 45(11): 2753–2786. Dostupné z DOI: <https://doi.org/10.2337/dci22–0034>.
  63. Broomfield PH, Chopra R, Sheinbaum RC et al. Effects of ursodeoxycholic acid and aspirin on the formation of lithogenic bile and gallstones during loss of weight. N Engl J Med 1988; 319(24): 1567–1572. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJM198812153192403>.
  64. Achufusi TG, Safadi AO, Mahabadi N. Ursodeoxycholic Acid. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing 2025. Dostupné z WWW: <https://www.ncbi.nlm.nih.gov/books/NBK545303/>.
  65. Haal S, Guman MSS, Boerlage TC et al. Ursodeoxycholic acid for the prevention of symptomatic gallstone disease after bariatric surgery (UPGRADE): a multicentre, double-blind, randomised, placebo-controlled superiority trial. Lancet Gastroenterol Hepatol 2021; 6(12): 993–1001. Dostupné z DOI: <http://dx.doi.org/10.1016/S2468–1253(21)00301–0>.
  66. Sugerman HJ, Brewer WH, Shiffman ML et al. A multicenter, placebocontrolled, randomized, double-blind, prospective trial of prophylactic ursodiol for the prevention of gallstone formation following gastric-bypass-induced rapid weight loss. Am J Surg 1995; 169(1): 91–96; discussion 96–97. Dostupné z DOI: <http://dx.doi.org/10.1016/s0002–9610(99)80115–9>.
  67. Coupaye M, Calabrese D, Sami O et al. Evaluation of incidence of cholelithiasis after bariatric surgery in subjects treated or not treated with ursodeoxycholic acid. Surg Obes Relat Dis 2017; 13(4): 681–685. Dostupné z DOI: <http://dx.doi.org/10.1016/j.soard.2016.11.022>.
  68. Worobetz LJ, Inglis FG, Shaffer EA. The effect of ursodeoxycholic acid therapy on gallstone formation in the morbidly obese during rapid weight loss. Am J Gastroenterol 1993; 88(10): 1705–1710.
  69. URSOSAN. 250 mg kapsuly. Dostupné z WWW: <https://www.adc.sk/databazy/produkty/spc/ursosan-707362.html>.
  70. [European Association for the Study of the Liver; European Association for the Study of Diabetes; European Association for the Study of Obesity]. EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD): Executive Summary. Diabetologia 2024; 67(11): 2375–2392. Dostupné z DOI: <http://dx.doi.org/10.1007/s00125–024–06196–3>. Erratum in: Diabetologia 2024; 67(11): 2608. Dostupné z DOI: <http://dx.doi.org/10.1007/s00125–024–06258–6>.
  71. Zhang W, Tang Y, Huang J et al. Efficacy of ursodeoxycholic acid in nonalcoholic fatty liver disease: An updated meta-analysis of randomized controlled trials. Asia Pac J Clini Nutr 2020; 29(4): 696–705. Dostupné z DOI: <http://doi:10.6133/apjcn.202012_29(4).0004>.
  72. Dostupné z WWW: <https://www.adc.sk/databazy/produkty/spc/ursosan-158564.html?>. 2025
  73. Stokes CS, Lammert F. Excess Body Weight and Gallstone Disease. Visc Med 2021; 37(4): 254–260. Dostupné z DOI: <http://dx.doi.org/10.1159/000516418>.
  74. Worni M, Guller U, Shah A et al. Cholecystectomy concomitant with laparoscopic gastric bypass: a trend analysis of the nationwide inpatient sample from 2001 to 2008. Obes Surg 2012; 22(2): 220–229. Dostupné z DOI: <http://dx.doi.org/10.1007/s11695–011–0575-y>.
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