Abstract
This study was aimed at investigating whether it is possible, on the basis of the presence of multiple factors, to select a population with a higher prevalence of gallstones than that predicted simply on the basis of age and sex. Thus, we selected and screened for the presence of previously undiagnosed gallstones subjects with at least four of the following variables: female sex, age over 40, obesity, diabetes, biliary colic, family history of gallstones or cholecystectomy, hypertriglyceridemia, parity, and oral contraceptive use. Thea priori probability (or expected prevalence) of having previously undiagnosed gallstones was calculated for each subject on the basis of sex and age according to data derived from epidemiological studies performed in Italy in the general population. among the 821 males and 3930 females participating in this study, previously undiagnosed gallstones (GS) were found in 135 (16.4%) males and 691 (17.6%) females. The ratio between observed and expected prevalence of GS was higher in males (3.09) than in females (2.32). The highest ratios between observed and expectted prevalence of GS were found in the lowest classes of expected prevalence in both sexes. The best predictors of the presence of GS were age, biliary colic, and diabetes in males and age, biliary colic, obesity, and number of pregnancies in females. It is concluded that selection of subjects with multiple factors associated with GS increases thea priori probability of GS diagnosis by a factor 2 in females or 3 in males. Stricter selection criteria should be used for fermales.
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The Rome Grup for the Epidemiology and Prevention of Cholelithiasis (GREPCO). Prevalence of gallstone disease in an Italian adult female propulation. Am J Epidemiol 119:796–805, 1984
The Rome Group for the Epidemiology and Prevention of Cholelithiasis (GREPCO): The epidemiology of gallstone disease in Rome, Italy. Part I. Prevalence data in men. Hepatology 8:904–906, 1988
The Rome Group for the Epidemiology and Prevention of Cholelithiasis (GREPCO): The epidemiology of gallstone disease in Rome, Italy, Part II. Factors associated with the discase. Hepathology 8:907–913, 1988
Barbara L, Sama C, Morselli Labate AM, Taroni F, Rusticali AG, Festi D, Sapio C, Roda E, Baterle C, Puci A, Formentini F, Colasanti S, Nardin F: A population study on prevalence of gallstone disease: the Sirmione study. Hepathology 7:913–917, 1987
Palasciano G, Portincasa P, Vinciguerra V, Velardi MD, Tardi S, Baldassarre G, Albano MD: Gallstone prevalence and gallbladder volume in children and adolescents: An epidemiological ultrasonographic survey and relationship to Body Mass Index. Am J Gastroenterol 84:1378–1382, 1989
Jorgensen T: Prevalence of gallstones in a Danish Population. Am J Epidemiol 126:912–921, 1987
Glambek I, Kvaale G, Arnesjo B, Soreide O: Prevalence of gallstones in a Norwegian population. Scand J Gastroenterol 22:1089–1094, 1987
Nomura H, Kashiwagi S, Hayashi J, Kajiyama W, Ikematsu H, Noguchi A, Tani S, Goto M: Prevalence of gallstone disease in a general population of Okinawa, Japan. Am J Epidemiol 128:598–605, 1988
Capocaccia L, GREPCO: Clinical symptoms and gallstone disease: Lessons from a population study.In L Capocacci, G Ricci, F Angelico, M Angelico, AF Attili (eds). Epidemiology and Prevention of Gallstone Disease. Lancaster, MTP Press, 1984, pp 153–157
Festi D, Lalloni L, Taroni F, MICOL Study Grup: Inter-and intra-observer variation in ultrasonographic detection of gallstones: The Multicenter Italian Study on Epidemiology of Cholelithiasis (M.I.COL.). Eur J Epidemiol 5:51–57, 1989
Attili AF, Carulli N, Roda E, Barbara B, Capocaccia L, Menotti A, Okoliksanyi L, Ricci G, Capocaccia R, Festi D, Lalloni L, Mariotti S, Sama C, Scafato E, the M.I.COL. Group: Epidemiology of gallstone disease in Italy: Prevalence data of the Multicenter Italian Study on Cholelithiasis (M.I.COL.). Am J Epidemiol 141:158–165, 1995
Strom BL, Tamragouri RN, Morse ML: Oral contraceptives and risk factors for gallbladder disease. Clin Pharmacol Ther 39:335–341, 1986
Scragg RKR, McMichael AL, Scamark RF: Diet, alcohol and relative weight in gallstone disease: A case control study. Br Med J 288:1113–1119, 1984
Shoenfield LJ, Carulli N, Dowling RH, Sama C, Wolpers C: Asymptomatic gallstones: definition and treatment. Gastroenterol Int 2:25–29, 1989
Gracie WA, Ransohoff DF: The natural history of silent gallstones. The “innocent” gallstone is not a myth. N Engl J Med 307:798–800, 1982
Ransohoff DF, Gracie WA, Wolfenson LB, Neuhauser D: Prophylactic cholecystectomy or expectant management for silent gallstones. Ann Intern Med 99:199–204, 1983
Attili AF, De Santis A, Capri R, Repice AM, Maselli S, GREPCO: The natural history of gallstones: The GREPCO experience. Hepatology 21:656–660, 1995
Friedman GD, Raviola CA, Fireman B: Prognosis of gallstones with mild or no symptoms: 25 years of follow up in a health maintenance organization. J Clin Epidemiol 42:127–136, 1989
Rome Group for the Epidemiology and Prevention of Cholelithiasis (GREPCO): Radiologic appearance of gallstones and its relationship with biliary symptoms and awareness of having gallstones. Observations during epidemiological studies. Dig Dis Sci 32:349–353, 1987
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Attili, A.F., Pazzi, P. & Galeazzi, R. Prevalence of previously undiagnosed gallstones in a population with multiple risk factors. Digest Dis Sci 40, 1770–1774 (1995). https://doi.org/10.1007/BF02212700
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DOI: https://doi.org/10.1007/BF02212700