Abstract
In order to analyze the factors associated with cholelithiasic disease, 1268 participants of a population sample were studied. On univariate analysis, 11 of the 23 variables included showed a statistically significant association (P < 0.05). Five of these variables, including obesity, triglyceride level, intake of hypolipidemic drugs, and a diet rich in cholesterol and saturated fats in women, and physical exercise in men, remained significantly associated after controlling for age. On multivariate analysis among women, a positive association was found with age (P < 0.001), obesity, and the use of hypolipidemic agents (P < 0.05) and a negative one with a diet rich in cholesterol and saturated fats (P < 0.05). Among men, the same analysis revealed there was a positive association with age (P < 0.001) and triglycerides (P < 0.05) and a negative one with physical exercise (P < 0.05). In conclusion, obesity and the use of hypolipidemic agents in women and triglycerides in men, were positively associated with cholelithiasic disease, independent of age, while negative associations included the intake of cholesterol and saturated fats in women and physical exercise in men.
Similar content being viewed by others
References
Davion T, Capron J-P: Fr;Epidemiologie et facteurs de risque de la lithiase biliaire. S Erlinger (eds). In La lithiase biliaire, Paris, Doin Editeurs, 1991, pp 1–15.
Bennion LJ, Grundy ST: Risk factors for the development of cholelithiasis in man. N Engl J Med 299:o1221–1227, 1978
Davion T, Capron JP: Facteurs de risque de la lithiase biliaire choleste´rolique. Bilan du septennat. Gastroenterol Clin Biol 12:649–660, 1988
Teres J: Epidemiologia, factores de riesgo y patogenia de la litiasis biliar. Gastroenterol Hepatol 16:630–635, 1993
Ros Rahola E: Litiasis biliar: Evolucion conceptual y revolucion terapeutica. Med Clin (Barc) 90:297–305, 1988
Maurer KR, Everhart JE, Ezzati TE, Johannes RS, Knowler WC, Larson DL, Sanders R, Shawker TH, Roth HP: Prevalence of gallstone disease in Hispanic populations in the United States. Gastroenterology 96:487–492, 1989
Sampliner RE, Bennett PH, Comess LJ, Rose FA, Bruch TA: Gallbladder disease in Pima indians. Demonstration of high prevalence and early onset by cholecistography. N Engl J Med 283:1358–1364, 1970
Bertomeu A, Ros E, Zambon D, Vela M, Perez-Ayuso RM, Targarona E, Trias M, Sanllehy C, Casals E, Ribo JM: Apolipoprotein E Polymorphism and Gallstones. Gastroenterology 111:1603–1610, 1996
Van Erpecum KJ, Carey MC: Apolipoprotein E4: Another risk factor for cholesterol gallstone formation ? Gastroenterology 111:1764–1767, 1996
Strom BL, West SL: Epidemiologia de la litiasis biliar. In Colelitiasis. S Cohen, S, RD Soloway (eds). Madrid, SANED, 1985, pp 1–26
Teres J: Epidemiologia y factores de riesgo de la litiasis biliar. In Actualidades en Gastroenterologia y Hepatologia (13), Litiasis biliar. J Rodes, C Chantar (eds). Barcelona, JR Prous, 1993, pp 35–41
Jorgensen T, Jorgensen LM: Gallstones and diet in a Danish population. Scand J Gastroenterol 24:821–826, 1989
Lee SP, Carey MC, LaMont JT: Aspirin prevention of cholesterol gallstone formation in prairie dogs. Science 211:1429–1431, 1981
Barbara L, Sama C, Labate AML, Taroni F, Rusticali AG, Festi D, Sapio C, Roda E, Banterle C, Puci A, Formentini F, Colasanti S, Nardin F: A population study on the prevalence of gallstone disease: The Sirmione study. Hepatology 7:913–917. 1987
Jorgensen T: Gall stones in a Danish population. Relation to weight, physical activity, smoking, coffe consumption, and diabetes mellitus. Gut 30:528–534, 1989
Walker ARP, Segal I, Posner R, Shein H, Tsotetsi NG, Walker AJ: Prevalence of gallstones in elderly black women in Soweto, Johannesburg, as assessed by ultrasound. Am J Gastroenterol 84:1383–1385, 1989
Everhart JE: Contributions of obesity and weight loss to gallstone disease. Ann Intern Med 119:1029–1035, 1993
Maclure KM, Hayes KC, Colditz GA, Stampfer MJ, Speizer FE, Willett WC: Weight, diet, and the risk of symtomatic gallstones in middle-aged women. N Engl J Med 321:563–569, 1989
Stampfer MJ, Maclure MK, Colditz GA, Manson JE, Willet WC: Risk of symptomatic gallstones in women with severe obesity. Am J Clin Nutr 55:652–658, 1992
Mellströo D, Asztély M, Svanvik J: Gallstones and previous cholecystectomy in 77–to 78–year-old women in an urban population in Sweden. Scand J Gastroenterol 23:1241–1244, 1988
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, 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(2):158–165, 1995
Jorgensen T, Kay L, Schultz-Larsen K: The epidemiology of gallstones in a 70–year old Danish population. Scand J Gastroenterol 25:335–340, 1990
Palasciano G, Portincasa P, Vinciguerra V, Velardi A, Tardi S, Baldasarre G, Albano O: 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
Martinez de Pancorbo M: Litiasis biliar: Prevalencia y factores asociados en poblacion general. Doctoral thesis. Universidad Alcala de Henares. Fac. de Medicina, 1992
Kono S, Shichi K, Ikeda N, Yanai F, Imanishi K: Prevalence of gallstone disease in relation to smoking, alcohol use, obesity, and glucose tolerance: A study of self-defense officials in Japan. Am J Epidemiol 136:787–794, 1992
Kato I, Nomura A, Stemmermann GN, Chyou P: Prospective study of clinical gallbladder disease and its association with obesity, physical activity, and other factors. Dig Dis Sci 37:784–790, 1992
GREPCO (Rome Group for Epidemiology and prevention of cholelithiasis): The epidemiology of gallstone disease in Rome, Italy, Part II, Factors associated with the disease. Hepatology 8:907–913, 1988
Capron JP, Delamarre J, Herve MA, Dupas JL, Poulain P, Descombes P: Meal frequency and duration of overnight fast: A role in gall-stone formation. Br Med J 283:1435, 1981
Marks JW, Bonorris GG, Albers G, Schoenfield LJ: The sequence of biliary events preceding the formation of gallstones in humans. Gastroenterology 103:566–570, 1992
Kamrath R, Plummer LJ, Sadur CN, Adler MA, Strader WJ, Young RL, Weinstein RL: Cholelithiasis in patients treated with a very-low-calorie diet. Am J Clin Nutr 56:255S–257S, 1992
Yang H, Petersen GM, Roth MP, Schonefield LJ, Marks JW: Risk factors for gallstone formation during rapid loss of weight. Dig Dis Sci 37:912–918, 1992
Messing B, Boris C, Kunstlinger F, Bernier JJ: Does total parenteral nutrition induce gallbladder sludge formation and lithiasis? Gastroenterology 84:1012–1019, 1983
Shiffman ML, Sugerman HJ, Kellum JM, Brewer WH, Moore EW: Gallstone formation after rapid weight loss: a prospective study in patients undergoing gastric bypass surgery for treatment of morbid obesity. Am J Gastroenterol 86:1000–1005, 1991
Bennion LJ, Grundy SM: Effects of diabetes mellitus on cholesterol metabolism in man. N Engl J Med 296:1365–1371, 1977
Fiorucci S, Bosso R, Scionti L, Disanto S, Annibale B, Delle Fave G, Morelli A: Neurohumoral control of gallbladder motility in healthy subjects and diabetic patients whith or without autonomic neuropathy. Dig Dis Sci 35:1089–1097, 1990
Wedmann B, Droge C, Amoiridis G, Schmidt-Heinevetter G, Wegener M, Ricken D: Gallbladder motility in diabetic patients with and without cardiovascular neuropathy. Z Gastroenterol 30:519–524, 1992
Abdel-Rahman HA, Hafez AS, Maymoun NM, el-Gendy SD, Abdo AS, Yonis AM, Abdel-Aziz S: Risk factors of gallstone disease in a sample of patients in Benha City. J Egypt Public Health Assoc 68:205–227, 1993
GREPCO (Rome Group for Epidemiology and Prevention of Cholelithiasis): Prevalence of gallstone disease in an italian adult female population. Am J Epidemiol 119:796–805, 1984
Khuroo MS, Mahajan R, Zargar SA, Javid G, Sapru S: Prevalence of biliary tract disease in India: A sonographic study in adult population in Kashmir. Gut 30:201–205, 1989
Rusticali AG, Sama C, Morselli Labate AM, Frabboni R, Nacchiero MC, Tassinari G, Barbara L: The Boario project. A study of the prevalence of lithiasis in a spa population. Minerva Med 81:301–306, 1990
Jorgensen T: Gall stones in a Danish population: Fertility period, pregnancies, and exogenus female sex hormones. Gut 29:433–439, 1988
Glasinovic JC, Marinovic I, Mege R, Vela P, Fernandez de la Reguera P, Ahumada E, Valdivia MT, Alvarado A, Scrivanti M: Prevalencia de colelitiasis en mujeres nuliparas en edad fertil. Gastroenterol Hepatol 16:111–115, 1993
Glasinovic JC, Marinovic I, Mege R, Vela P, Ferreiro O, Ahumada E, Tobar E, Valdivia MT, Alvarado A: Efecto del embarazo sobre la incidencia y la prevalencia de colelitiasis. Gastroenterol Hepatol 16:61–66, 1993
Valdivieso V, Covarrubias C, Siegel F, Cruz F: Pregnancy and cholelitiasis: Pathogenesis and natural course of gallstones diagnosed in early puerperium. Hepatology 17:1–4, 1993
Maringhini A, Ciambra M, Baccelliere E, Raimondo M, Orlando A, Tinè F, Grasso R, Randazzo MA, Barresi L, Gullo D, Musicò M, Pagliaro L: Biliari sludge and gallstones in pregnancy: Incidence, risk factors, and natural history. Ann Intern Med 119:116–120, 1993
Everson GT: Pregnancy and gallstones. Hepatology 17:159–161, 1993
Barbara L, Cornia GL, Festi D, Frabboni R, Morselli-Labate AM, Nacchiero MC, Parro S, Pollini G, Roda E, Rossi M, Rusticali AG, Sama C, Taroni F, Tassinari G, Banterle C, Colasanti S, Formentini G, Moreni O, Nardin F, Pilia MC, Puci C: Dietari habit and incidence of gallstones in the “Sirmione Study.” Hepatology 10:736, 1989 (abstract)
Bates T, Harrison M, Lowe D, Lawson G, Padley N: Longitudinal study of gall stone prevalence at necropsy. Gut 33:103–107, 1992
Festi D, Orsini M, Colecchia A, Sottili S, Sangermano A, Mazzella G, Villanova N, Petroni ML, Pavesi S, Roda E: Gallbladder motility and gallstone formation during rapid weigth loss induced by very low calorie diets: A present con-firmation of an old clinical observation. Gastroenterology 110:A663, 1996
Pallotta N, Cicala M, Frandina C, Corazziari E, and Torsoli A: Gallbladder recycling of hepatic bile after meals with different fat contents. Gastroenterology 110:A728, 1996
Lefkof IR, Marks JW, Schonfield LJ: La dieta en la formacion y tratamiento de los calculos biliares de colesterol. In Colelitiasis. S Cohen, RD Soloway (eds). Madrid, SANED, 1985, pp 113–127
Simon JA: Ascorbic acid and cholesterol gallstones. Med Hypoth 40:81–84, 1993
Thornton J, Symes C, Heaton K: Moderat alcohol intake reduces bile cholesterol saturation and raises HDL cholesterol. Lancet 2:819–822, 1983
Pastides H, Tzonou A, Trichopoulos D, Katsouyanni K, Trichopoulos 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
Scraag RKR, McMichael AJ, Baghurs PA: Diet, alcohol and relative weight in gallstone disease: A case control study. Br Med J 40:81–84, 1984
Pixley F, Mann J: Dietary factors in the aetiology of gall stones: A case control study. Gut 29:1511–1515, 1988
Thijs C, Knipschild P: Oral contraceptives and the risk of gallbladder disease: A meta-analysis. Am J Public Health 83:1113–1120, 1993
Duane WC, Hunninghake DB, Freeman ML, Pooler PA, Schlasner LA, Gebhart RL: Simvastatin, a competitive inhibitor of HMG-CoA reductase, lowers cholesterol saturation index of gallbladder bile. Hepatology 8:1147–1150, 1988
Hoogerbrugge Van Den Linden N, Linden N, de Rooy FWM, Jansen H, Van Blankenstein M: Effect of pravastatin on biliary lipid concentration and bile acid synthesis in familial hypercholesterolaemia. Gut 31:348–350, 1990
Broomfield PH, Chopra R, Sheinbaum RC, Bonorris GG, Silverman A, Schoenfield LJ, Marks JW: Effects of ursodesoxycholic acid and aspirin on the formation of lithogenic bile and gallstones during loss of weight. N Engl J Med 319:1567–1572, 1988
Adamek HE, Buttmann A, Weber J, Riemann JF: Can aspirin prevent gallstone recurrence after successful extracorporeal schockwave lithotripsy? Scand J Gastroenterol 29:355–359, 1994
Kurata JH, Marcks J, Abbey D: One gram of aspirin per day does not reduce risk of hospitalization for gallstone disease. Dig Dis Sci 36:1110–1115, 1991
Hood KA, Gleeson D, Ruppin DC, Dowling RH, British-Belgian Gall Stone Study Group: Gall stone recurrence and its prevention: The British/Belgian gall stone study group's postdissolution trial. Gut 34:1277–1288, 1993
Hood K, Ruggpin DC, Gleeson D, Dowling RH: Prevention of gallstone recurrence by non-steroidal anti-inflammatory drugs. Lancet. 2:1223–1225, 1988
Criqui MH, Wallace RB, Heiss G, Mishkel M, Schonfeld G, Jones GTL: Cigarette smoking and plasma high-density lipoprotein cholesterol. The lipid research clinics program prevalence study. Circulation 62(suppl 4):70–76, 1980
Stamford BA, Matter S, Fell RD, Sady S, Cresanta MK, Papanek P: Cigarette smoking, physical activity, and alcohol consumption: Relationship to blood lipids and lipoproteins in premenopausal females. Metabolism 33:585–590, 1984
Thornton JR, Heaton KW, MacFarlane DG: A relation between high-density-lipoprotein cholesterol and bile cholesterol saturation. Br Med J 283:1352–1354, 1981
Scragg RKR, Calvert GD, Oliver JR: Plasma lipids and insulin in gallstone disease: A case- control study. Br Med J 289:521–525, 1984
Hartung GH, Foreyt JP, Mitchell RE, Vlasek I, Gotto AM Jr: Relation of diet to high-density-lipoprotein cholesterol in middle-aged marathon runners, joggers, and inactive men. N Engl J med 302:357–361, 1980
Marcus SN, Heaton KW: Intestinal transit, deoxycholic acid and the cholesterol saturation of bile: Three inter-related factors. Gut 27:550–558, 1986
Heaton KW, Braddon FEM, Mountford RA, Hughes AO, Emmett PM. Symptomatic and silent gall stones in the community. Gut 32:316–320, 1991
Heaton KW, Emmet PM, Symes CL, Braddon FEM: An explanation for gallstones in normal-weight women: slow intestinal transit. Lancet 341:8–10, 1993
Jorgensen T: Gallstones and plasma lipids in a Danish population. Scand J Gastroenterol 24:916–922, 1989
Janzon L, Aspelin P, Eriksson S, Hildell J, Trell E, Ostenberg H: Ultrasonographic screening for gallstone disease in middleage women: Detection rate, symptoms and biochemical features. Scand J Gastroenterol 20:706–710, 1985
Montalto G, Soresi M, Carroccio A, Averna MR, Muratore R, Li Castri C, Barbagallo CM, Cavera G, Sapienza M, Notarbartolo A: Prevalence of biliary lithiasis in the elderly people of small town in Sicily. Age Ageing 21:338–342, 1992
Thijs C, Knipschild P, Brombacher P: Serum lipids and gallstones: A case-control study. Gastroenterology 99:843–849, 1990
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. m J Epidemiol 128:598–605, 1988
Holzbach RT, Kibe A, Thiel E, Howel JH, Marsh M, Hermann RE: Biliary Proteins. J Clin Invest 73:35–45, 1984
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Devesa, F., Ferrando, J., Caldentey, M. et al. Cholelithiasic Disease and Associated Factors in a Spanish Population. Dig Dis Sci 46, 1424–1436 (2001). https://doi.org/10.1023/A:1010631619162
Issue Date:
DOI: https://doi.org/10.1023/A:1010631619162