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.
Similar content being viewed by others
REFERENCES
Bennion LJ, Grundy SM: Risk factors for the development of cholelithiasis in man. N Engl J Med 22:1221-1227, 1978
Bennion LJ, Grundy SM: Effects of obesity and caloric intake on biliary lipid metabolism in man. J Clin Invest 56:996-1011, 1975
Amaral JF, Thompson WR: Gallbladder disease in the morbidly obese. Am J Surg 149:551-557, 1985
Calhoun RC, Willbanks O: Coexistence of gallbladder disease and morbid obesity. Am J Surg 154:655-658, 1987
Baron JA, Logan RFA: Smoking and gallstones. In Smoking and Hormone Related Disease. N Wald, JA Baron (eds). Oxford, Oxford University Press, 1990
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
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
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
Rhodes M, Venables CW: Symptomatic gallstones: A disease of nonsmokers? Digestion 49:221-226, 1991
Strom BL, Tamragouri RN, Morse ML: Oral contraceptives and other risk factors for gallbladder disease. Clin Pharmacol Ther 39:335-341, 1986
Scragg RKR, McMichael AJ, Seamark RF: Oral contraceptives, pregnancy and endogenous estrogen in gallstone disease: a case-control study. BMJ 288:1795-1799, 1984
Lieber MM: The incidence of gallstones and their correlation with other diseases. Ann Surg 135:394-405, 1952
Feldman M, Feldman M Jr: The incidence of cholelithiasis, cholesterosis, and liver disease in diabetes mellitus. An autopsy study. Diabetes 3:305-307, 1954
Jorgensen T: Gallstones in Danish population. Relation to weight, physical activity, smoking, coffee consumption, and diabetes mellitus. Gut 30:528-534, 1989
Bartoli E, Ferrari E, Saporetti N, Rossi L: Prevalence of cholelithiasis in diabetes mellitus: A cholecystosonographic study. Rays 12:43-46, 1987
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
Persson GE, Thulin AJG: Prevalence of gallstone disease in patients with diabetes mellitus. Eur J Surg 157:579-582, 1991
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
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
World Health Organization: Diabetes mellitus report of a WHO Study Group. Technical report 727. Geneva, World Health Organization, 1985
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
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
MacMahon B, Trichopoulos D, Cole P, Brown J: Cigarette smoking and urinary estrogens. N Engl J Med 307:1062-1065, 1982
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
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
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
Petitti DB, Sidney S, Perlman JA: Increased risk of cholecystectomy in users of supplemental estrogens. J Am Gastroenterol Assoc 94:91-95, 1988
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
Levy P, Smith BF, LaMont JT: Human gallbladder mucin accelerates in vitro nucleation of cholesterol in artificial bile. Gastroenterology 87:270-275, 1984
Ikard RW: Gallstones, cholecystitis and diabetes. Surg Gynecol Obstet 171:528-532, 1990
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
Shreiner DP, Sarva RP, Van Thiel D, Yingvorapant N: Gallbladder function in diabetic patients. J Nucl Med 27:357-360, 1986
Braverman DZ: The lack of effect of metoclopramide on gallbladder volume and contraction in diabetic cholecystoparesis. Am J Gastroenterol 81(10):960-962, 1986
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
Author information
Authors and Affiliations
Rights 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
Issue Date:
DOI: https://doi.org/10.1023/A:1005544009372