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Background/Aims: We sought to examine whether the presenceof gallstone disease (GD) in patients with biopsy-provennonalcoholic fatty liver disease (NAFLD) is associated withliver fibrosis and histological nonalcoholic steatohepatitis(NASH) score. Methods: We included 441 Turkish patientswith biopsy-proven NAFLD. GD was diagnosed in the presenceof sonographic evidence of gallstones, echogenic materialwithin the gallbladder with constant shadowing and littleor no visualization of the gallbladder or absence of gallbladderat ultrasonography, coupled with a history of cholecystectomy. Results: Fifty-four patients (12.2%) had GD (GD+subjects). Compared with the GD- subjects, GD+ patientswere older, had a higher body mass index and were morelikely to be female and have metabolic syndrome. However,GD+ patients did not have a higher risk of advanced fibrosisor definite NASH on histology. After adjustment for potentialconfounding variables, the prevalence of GD in NAFLD patientswas not associated with significant fibrosis (≥2) (oddsratio [OR], 1.06; 95% confidence interval [CI], 0.53 to 2.21;p=0.68) or definite NASH (OR, 1.03; 95% CI, 0.495 to 2.12;p=0.84). Conclusions: The presence of GD is not independentlyassociated with advanced fibrosis and definite NASHin adult Turkish patients with biopsy-proven NAFLD

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