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Gender and Gallstone Disease

Gender und Gallensteine

Wiener Medizinische Wochenschrift volume 156, pages 527–533 (2006)Cite this article

Zusammenfassung

Gallensteine zählen weltweit zu den häufigsten Erkrankungen. In den westlichen Ländern sind etwa 80 % der Gallensteine Cholesterinsteine. Für die Gallensteinbildung sind einige Risikofaktoren bekannt. Zu den wichtigsten zählt das weibliche Geschlecht. Frauen haben gegenüber Männern ein 2- bis 3-fach erhöhtes Risiko für Gallensteine, das jedoch hauptsächlich auf das gebärfähige Alter beschränkt ist. Ein weiterer Risikofaktor sind Schwangerschaften, wobei das Risiko mit der Anzahl der Schwangerschaften ansteigt. Für das erhöhte Gallensteinrisiko sind weibliche Sexualhormone verantwortlich. Östrogen bewirkt eine vermehrte Cholesterinsekretion in die Galle und steigert dadurch die Cholesterinsättigung. Daher sind auch Hormonersatztherapien für Frauen in der Menopause und orale Kontrazeptive mit einem erhöhten Risiko für Gallensteine verbunden. Da jedoch der Effekt von Östrogen dosisabhängig ist, kann für neuere orale Kontrazeptive mit niedriger Östrogendosis das erhöhte Risiko nicht mehr nachgewiesen werden. Im Mittelpunkt des vorliegenden Artikels stehen die genannten, mit weiblichen Sexualhormonen assoziierten Risikofaktoren für die Gallensteinbildung.

Summary

Gallstone disease is a common disorder all over the world. In the Western societies about 80 % of the gallstones are composed primarily of cholesterol. Several risk factors for gallstone formation have been identified. One of the most important risk factors is female gender. Rates of gallstones are two to three times higher among women than men. But this is primarily a phenomenon of the childbearing age. Pregnancy is also a major risk factor for gallstone formation. The risk is related to the number of pregnancies. Sex hormones are most likely to be responsible for the increased risk. Estrogen increases biliary cholesterol secretion causing cholesterol supersaturation of bile. Thus, hormone replacement therapy in postmenopausal women and oral contraceptives have also been described to be associated with an increased risk for gallstone disease. However, the effect of estrogen is dose-dependent and new oral contraceptives with a low estrogen dose do not seem to increase the rate of gallstone formation. The present article focuses on the mentioned risk factors associated with female sex hormones.

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Authors and Affiliations

  1. Department of Internal Medicine IV, Division of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria

    Gottfried Novacek

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  1. Gottfried Novacek
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Correspondence to Gottfried Novacek.

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Novacek, G. Gender and Gallstone Disease. Wien Med Wochenschr 156, 527–533 (2006). https://doi.org/10.1007/s10354-006-0346-x

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Schlüsselwörter

  • Gallensteine
  • Geschlecht
  • Schwangerschaft
  • Hormonersatztherapie
  • Orale Kontrazeptiva
  • Östrogen
  • Progesteron

Keywords

  • Gallstones
  • Gender
  • Pregnancy
  • Hormone replacement therapy
  • Oral contraceptives
  • Estrogen
  • Progesterone