CRP and inflammatory response: Chronic inflammation, as indicated by elevated C-reactive protein (CRP) levels, promotes cholesterol precipitation by altering hepatic lipid metabolism and bile acid synthesis.[8] At the same time, insulin resistance exacerbates biliary cholesterol overproduction by dysregulating sterol regulatory element-binding proteins, leading to cholecystic stagnation through autonomic neuropathy.[2] Insulin resistance is indicated by the triglyceride-glucose index (TyG).