Skip to main content
Log in

Association of Obesity and Type II Diabetes Mellitus as a Risk Factor for Gallstones

  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

Age, female sex, and obesity are well-known risk factors for gallstones; in contrast the possible role of type 2 diabetes mellitus (type-2 DM) is controversial. One reason for this discrepancy might be that type 2 DM is often accompanied by obesity. Therefore, the aim of this study was to evaluate the importance of obesity and of type 2 DM, separately and together, as risk factors for gallstones. In all, 203 obese patients with normal glucose tolerance (obese NGT), 446 obese patients with type 2 DM (obese type 2 DM), 269 lean patients with type 2 DM (lean type 2 DM) and 250 lean subjects with a normal glucose tolerance (lean NGT) were evaluated by ultrasonography for the presence of gallstones. At univariate analysis patients with gallstones (177) were older and were more frequently affected by both obesity and type 2 DM, and had higher triglycerides and fasting blood glucose levels. At multiple logistic regression analysis, only age and obesity, both in the presence or in absence of type 2 DM, were strongly associated with gallstones (P < 0.001); diabetes alone had a lower level of statistical significance (P = 0.07). These data suggest that obesity is a stronger risk factor for gallstones than type 2 DM.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

REFERENCES

  1. Bennion LJ, Grundy SM: Risk factors for the development of cholelithiasis in man. N Engl J Med 22:1221-1227, 1978

    Google Scholar 

  2. Bennion LJ, Grundy SM: Effects of obesity and caloric intake on biliary lipid metabolism in man. J Clin Invest 56:996-1011, 1975

    Google Scholar 

  3. Amaral JF, Thompson WR: Gallbladder disease in the morbidly obese. Am J Surg 149:551-557, 1985

    Google Scholar 

  4. Calhoun RC, Willbanks O: Coexistence of gallbladder disease and morbid obesity. Am J Surg 154:655-658, 1987

    Google Scholar 

  5. Baron JA, Logan RFA: Smoking and gallstones. In Smoking and Hormone Related Disease. N Wald, JA Baron (eds). Oxford, Oxford University Press, 1990

    Google Scholar 

  6. Petitti DB, Friedmen GD, Klatsky AL: Association of a history of gallbladder disease with a reduced concentration of high-density lipoprotein cholesterol. N Engl J Med 304:1396-1398, 1981

    Google Scholar 

  7. Murray FE, Logan RFA, Hannaford PC, Kay CR: Cigarette smoking and parity as risk factors for the development of symptomatic gallbladder disease in women: Results of the Royal College of General Practitioners' oral contraception study. Gut 35:107-111, 1994

    Google Scholar 

  8. Pastides H, Tzonou A, Trichopoulos D, Katsouyanni K, Trichopoulou A, Kefalogiannis N, Manousos O: A case-control study of the relationship between smoking, diet and gallbladder disease. Arch Intern Med 150:1409-1412, 1990

    Google Scholar 

  9. Rhodes M, Venables CW: Symptomatic gallstones: A disease of nonsmokers? Digestion 49:221-226, 1991

    Google Scholar 

  10. Strom BL, Tamragouri RN, Morse ML: Oral contraceptives and other risk factors for gallbladder disease. Clin Pharmacol Ther 39:335-341, 1986

    Google Scholar 

  11. Scragg RKR, McMichael AJ, Seamark RF: Oral contraceptives, pregnancy and endogenous estrogen in gallstone disease: a case-control study. BMJ 288:1795-1799, 1984

    Google Scholar 

  12. Lieber MM: The incidence of gallstones and their correlation with other diseases. Ann Surg 135:394-405, 1952

    Google Scholar 

  13. Feldman M, Feldman M Jr: The incidence of cholelithiasis, cholesterosis, and liver disease in diabetes mellitus. An autopsy study. Diabetes 3:305-307, 1954

    Google Scholar 

  14. Jorgensen T: Gallstones in Danish population. Relation to weight, physical activity, smoking, coffee consumption, and diabetes mellitus. Gut 30:528-534, 1989

    Google Scholar 

  15. Bartoli E, Ferrari E, Saporetti N, Rossi L: Prevalence of cholelithiasis in diabetes mellitus: A cholecystosonographic study. Rays 12:43-46, 1987

    Google Scholar 

  16. Haffner SM, Diehl AK, Mitchell BD, Stern MP, Hazuda HP: Increased prevalence of clinical gallbladder disease in subjects with non-insulin-dependent diabetes mellitus. Am J Epidemiol 132(2):327-335, 1990

    Google Scholar 

  17. Persson GE, Thulin AJG: Prevalence of gallstone disease in patients with diabetes mellitus. Eur J Surg 157:579-582, 1991

    Google Scholar 

  18. Chapman BA, Wilson IR, Frampton CM, Chisholm RJ, Stewart NR, Eagar GM, Allan RB: Prevalence of gallbladder disease in diabetes mellitus. Dig Dis Sci 41:2222-2228, 1996

    Google Scholar 

  19. Saibene A, Pellicciotta G, Balconi G, Angeli E, Calderara A, Pontiroli AE, Pozza G: Ultrasonographic evaluation of gallbladder volume and contractility in diabetic patients of different ages. Diabete Metab 17:530-533, 1991

    Google Scholar 

  20. World Health Organization: Diabetes mellitus report of a WHO Study Group. Technical report 727. Geneva, World Health Organization, 1985

    Google Scholar 

  21. Pontiroli AE, Galli L: Duration of obesity is a risk factor for non-insulin-dependent diabetes mellitus, not for arterial hypertension or for hyperlipidaemia. Acta Diabetol 35(3):130-136, 1998

    Google Scholar 

  22. Michonovicz J, Hershcopf R, Nagayuma H, Bradlow H, Fishman J: Increased 2 hydroxylation of estradiol as a possible mechanism for the antiestrogenic effect of cigarette smoking. N Engl J Med 315:1305-1309, 1986

    Google Scholar 

  23. MacMahon B, Trichopoulos D, Cole P, Brown J: Cigarette smoking and urinary estrogens. N Engl J Med 307:1062-1065, 1982

    Google Scholar 

  24. Jensen J, Christiansen C, Rodbro P: Cigarette smoking, serum estrogen, and bone loss during hormone-replacement therapy early and after menopause. N Engl J Med 313:973-975, 1985

    Google Scholar 

  25. Jarnfelt-Samsioe A, Eriksson B, Leissner KH, Samsioe G: Gallbladder disease related to use of oral contraceptives and nausea in pregnancy. South Med J 78:1040-1043, 1985

    Google Scholar 

  26. Layde PM, Vessey MP, Yates D: Risk factors for gallbladder disease: A cohort study of young women attending family planning clinics. J Epidemiol Community Health 36:274-278, 1982

    Google Scholar 

  27. Petitti DB, Sidney S, Perlman JA: Increased risk of cholecystectomy in users of supplemental estrogens. J Am Gastroenterol Assoc 94:91-95, 1988

    Google Scholar 

  28. Kakar F, Weiss NS, Strite SA: Non contraceptive estrogen use and the risk of gallstone disease in women. Am J Public Health 78:564-566, 1988

    Google Scholar 

  29. Levy P, Smith BF, LaMont JT: Human gallbladder mucin accelerates in vitro nucleation of cholesterol in artificial bile. Gastroenterology 87:270-275, 1984

    Google Scholar 

  30. Ikard RW: Gallstones, cholecystitis and diabetes. Surg Gynecol Obstet 171:528-532, 1990

    Google Scholar 

  31. Bucceri AM, Brogna A, Ferrara R: Sonographic study of postprandial gallbladder emptying and common bile duct changes in patients with diabetes or cholelithiasis. Abdom Imag 19:427-429, 1994

    Google Scholar 

  32. Shreiner DP, Sarva RP, Van Thiel D, Yingvorapant N: Gallbladder function in diabetic patients. J Nucl Med 27:357-360, 1986

    Google Scholar 

  33. Braverman DZ: The lack of effect of metoclopramide on gallbladder volume and contraction in diabetic cholecystoparesis. Am J Gastroenterol 81(10):960-962, 1986

    Google Scholar 

  34. Palasciano G, Portincasa P, Belfiore A, Baldassarre G, Cignarelli M, Paternostro A, Albano O, Giorgino R: Gallbladder volume and emptying in diabetics: the role of neuropathy and obesity. J Intern Med 231:123-127, 1992

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Pacchioni, M., Nicoletti, C., Caminiti, M. et al. Association of Obesity and Type II Diabetes Mellitus as a Risk Factor for Gallstones. Dig Dis Sci 45, 2002–2006 (2000). https://doi.org/10.1023/A:1005544009372

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1005544009372

Navigation