Risk Factors Associated with Symptomatic Cholelithiasis in Taiwan: a Population-based Study

Overview

Journal BMC Gastroenterol

Publisher Biomed Central

Specialty Gastroenterology

Date 2011 Oct 18

PMID 21999925

Citations 35

Authors

Shih-Chang Hung

Kuan-Fu Liao

Shih-Wei Lai

Chia-Ing Li

Wen-Chi Chen

Affiliations

Soon will be listed here.

Abstract

Background: Cholelithiasis has become a major health problem in Taiwan. The predominant type of gallstone found in Asian populations differs from that in the West, indicating possible differences in the etiology and risk factors for cholelithiasis. The aim of this study is to investigate the risk factors for cholelithiasis using data representative of the general population.

Methods: We performed a population-based, case-control study in which we analyzed medical data for 3725 patients newly diagnosed with cholelithiasis and 11175 gender- and age-matched controls with no history of cholelithiasis, using information obtained from the 2005 Registry for Beneficiaries of the National Health Insurance Research Database. Coexisting medical conditions were included in the analysis. Relative risks were estimated by adjusted odds ratio (OR) and 95% confidence interval (CI) using a multivariate logistic regression analysis.

Results: After controlling for the other covariates, multivariate logistic regression analysis identified the following as risk factors for cholelithiasis (in descending order of contribution): Among all patients - hepatitis C (OR = 2.78), cirrhosis (OR = 2.47), hepatitis B (OR = 2.00), obesity (OR = 1.89), and hyperlipidemia (OR = 1.54); Among women - hepatitis C (OR = 3.05), cirrhosis (OR = 1.92), obesity (OR = 1.91), menopause (OR = 1.61), hepatitis B (OR = 1.54), and hyperlipidemia (OR = 1.49). Diabetes mellitus appeared to have a marked influence on the development of cholelithiasis but was not identified as a significant independent risk factor for cholelithiasis.

Conclusions: The risk factors for cholelithiasis were obesity, hyperlipidemia, hepatitis B infection, hepatitis C infection, and cirrhosis in both genders, and menopause in females. Despite differences in the predominate type of gallstone in Asian versus Western populations, we identified no unique risk factors among the population of Taiwan.

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References

Lu J, Hsiao W . Does universal health insurance make health care unaffordable? Lessons from Taiwan. Health Aff (Millwood). 2003; 22(3):77-88. DOI: 10.1377/hlthaff.22.3.77. View

Wittenburg H, Lammert F . Genetic predisposition to gallbladder stones. Semin Liver Dis. 2007; 27(1):109-21. DOI: 10.1055/s-2006-960174. View

Tsai C, Leitzmann M, Willett W, Giovannucci E . Dietary carbohydrates and glycaemic load and the incidence of symptomatic gall stone disease in men. Gut. 2005; 54(6):823-8. PMC: 1774557. DOI: 10.1136/gut.2003.031435. View

Sheen I, Liaw Y . The prevalence and incidence of cholecystolithiasis in patients with chronic liver diseases: a prospective study. Hepatology. 1989; 9(4):538-40. DOI: 10.1002/hep.1840090405. View

Barut I, Tarhan O, Baykal B, Demir M, Celikbas B . Higher incidence of cholelithiasis in chronic renal failure patients with secondary hyperparathyroidism undergoing peritoneal dialysis. Ren Fail. 2007; 29(4):453-7. DOI: 10.1080/08860220701260636. View

Misciagna G, Leoci C, Guerra V, Chiloiro M, Elba S, Petruzzi J . Epidemiology of cholelithiasis in southern Italy. Part II: Risk factors. Eur J Gastroenterol Hepatol. 1996; 8(6):585-93. DOI: 10.1097/00042737-199606000-00017. View

Tazuma S, Kajiyama G, Mizuno T, YAMASHITA G, Miura H, Kajihara T . A combination therapy with simvastatin and ursodeoxycholic acid is more effective for cholesterol gallstone dissolution than is ursodeoxycholic acid monotherapy. J Clin Gastroenterol. 1998; 26(4):287-91. DOI: 10.1097/00004836-199806000-00015. View

Huang J, Chang C, Wang J, Kuo H, Lin J, Shau W . Nationwide epidemiological study of severe gallstone disease in Taiwan. BMC Gastroenterol. 2009; 9:63. PMC: 2746226. DOI: 10.1186/1471-230X-9-63. View

Schirmer B, Winters K, Edlich R . Cholelithiasis and cholecystitis. J Long Term Eff Med Implants. 2005; 15(3):329-38. DOI: 10.1615/jlongtermeffmedimplants.v15.i3.90. View

10.

Tazuma S . Gallstone disease: Epidemiology, pathogenesis, and classification of biliary stones (common bile duct and intrahepatic). Best Pract Res Clin Gastroenterol. 2006; 20(6):1075-83. DOI: 10.1016/j.bpg.2006.05.009. View

11.

Chen C, Huang M, Yang J, Nien C, Etheredge G, Yang C . Prevalence and risk factors of gallstone disease in an adult population of Taiwan: an epidemiological survey. J Gastroenterol Hepatol. 2006; 21(11):1737-43. DOI: 10.1111/j.1440-1746.2006.04381.x. View

12.

Acalovschi M, Buzas C, Radu C, Grigorescu M . Hepatitis C virus infection is a risk factor for gallstone disease: a prospective hospital-based study of patients with chronic viral C hepatitis. J Viral Hepat. 2009; 16(12):860-6. DOI: 10.1111/j.1365-2893.2009.01141.x. View

13.

Ho K, Lin X, Yu S, Chen J, Wu C . Cholelithiasis in Taiwan. Gallstone characteristics, surgical incidence, bile lipid composition, and role of beta-glucuronidase. Dig Dis Sci. 1995; 40(9):1963-73. DOI: 10.1007/BF02208665. View

14.

Cirillo D, Wallace R, Rodabough R, Greenland P, LaCroix A, Limacher M . Effect of estrogen therapy on gallbladder disease. JAMA. 2005; 293(3):330-9. DOI: 10.1001/jama.293.3.330. View

15.

Ayantunde A, Agrawal A . Gallstone ileus: diagnosis and management. World J Surg. 2007; 31(6):1292-7. DOI: 10.1007/s00268-007-9011-9. View

16.

Bodmer M, Brauchli Y, Krahenbuhl S, Jick S, Meier C . Statin use and risk of gallstone disease followed by cholecystectomy. JAMA. 2009; 302(18):2001-7. DOI: 10.1001/jama.2009.1601. View

17.

Gonzalez M, Toso C, Zufferey G, Roiron T, Majno P, Mentha G . [When should cholecystectomy be practiced? Not always an easy decision]. Rev Med Suisse. 2006; 2(70):1586-92. View

18.

Meshikhes A . Asymptomatic gallstones in the laparoscopic era. J R Coll Surg Edinb. 2003; 47(6):742-8. View

19.

Lai S, Liao K, Lai H, Chou C, Cheng K, Lai Y . The prevalence of gallbladder stones is higher among patients with chronic kidney disease in Taiwan. Medicine (Baltimore). 2009; 88(1):46-51. DOI: 10.1097/MD.0b013e318194183f. View

20.

Ruhl C, Everhart J . Association of diabetes, serum insulin, and C-peptide with gallbladder disease. Hepatology. 2000; 31(2):299-303. DOI: 10.1002/hep.510310206. View