Central European Journal of Medicine

, Volume 9, Issue 1, pp 108–114 | Cite as

The predictors of cholelithiasis in female patients with metabolic syndrome

  • Doina-Clementina Cojocaru
  • Florin Mitu
  • Cristina Gena Dascălu
  • Alina Manole
  • Corina Dima-Cozma
Research Article


Cholesterol gallstone disease is often associated with the metabolic syndrome. Female gender is an unmodifiable risk factor for cholelithiasis and, in its turn, the metabolic syndrome features a sexual dimorphism which warns that a global approach might overlook important discrimination. We carried out a retrospective analytical case-control study in order to perform a comparative analysis between two groups of female patients with metabolic syndrome and gallstones (n=60) or without gallstones (n=65). All the patients were investigated by abdominal ultrasound and met at least three criteria for the diagnosis of metabolic syndrome. Cases and controls were compared regarding anthropometric measurements, a complex lipid profile, and liver function tests. The risks associated with the likelihood of gallstones were estimated by means of cross-tabulation. In order to rank the significant variables we developed a binary logistic regression model which identified lean body weight ≤ 46.44 kg (OR 0.165; 95% CI 0.045–0.611; P = 0.007), total cholesterol ≥ 4.9 mmol/L (OR 15.948; 95% CI 2.700–94.205; P = 0.002), and direct bilirubin > 5.1 µmol/L (OR 0.056; 95% CI 0.013–0.235; P < 0.001), as variables with significant probability of association with the risk of gallstones in women with metabolic syndrome.


Gallstones Metabolic syndrome Female 


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  1. [1]
    Shaffer E.A., Gallstone disease: Epidemiology of gallbladder stone disease, Best Pract. Res. Clin. Gastroenterol., 2006, 20(6), 981–996PubMedCrossRefGoogle Scholar
  2. [2]
    Méndez-Sánchez N., Chavez-Tapia N.C., Motola-Kuba D., Sanchez-Lara K., Ponciano-Rodríguez G., Baptista H., Ramos M.H., Uribe M., Metabolic syndrome as a risk factor for gallstone disease, World J. Gastoenterol., 2005, 11(11), 1653–1657Google Scholar
  3. [3]
    Grundy S.M., Cholesterol gallstones: a fellow traveler with metabolic syndrome? Am. J. Clin. Nutr., 2004, 80(1), 1–2PubMedGoogle Scholar
  4. [4]
    Alberti K.G., Eckel R.H., Grundy S.M., Zimmet P.Z., Cleeman J.I., Donato K.A., Fruchart J.C., James W.P., Loria C.M., Smith S.C. Jr., Harmonizing the metabolic syndrome. A joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association, Circulation, 2009, 120, 1640–1645Google Scholar
  5. [5]
    Kuk J., Ardern C.I., Age and sex differences in the clustering of metabolic syndrome factors, Diabetes Care, 2010, 33, 2457–2461PubMedCrossRefGoogle Scholar
  6. [6]
    Stinton L.M., Myers R.P., Shaffer E.A., Epidemiology of gallstones, Gastroenterol. Clin. N. Am., 2010, 39(2), 157–169CrossRefGoogle Scholar
  7. [7]
    Lobo R.A., Metabolic syndrome after menopause and the role of hormones, Maturitas, 2008, 60, 10–18PubMedCrossRefGoogle Scholar
  8. [8]
    Boland L.L., Folsom A.R., Rosamond W.D., Atherosclerosis Risk in Communities (ARIC) Study Investigators. Hyperinsulinemia dyslipidemia and obesity as risk factors for hospitalized gallbladder disease. A prospective study, Ann. Epidemiol., 2002, 12, 131–140PubMedCrossRefGoogle Scholar
  9. [9]
    Mosteller, R.D., Simplified calculation of body surface area, N. Engl. J. Med., 1987, 317(17), 1098 (letter)PubMedGoogle Scholar
  10. [10]
    Morgan D.J., Bray K.M., Lean body mass as a predictor of drug dosage. Implications for drug therapy, Clin. Pharmacokinet., 1994, 26(4), 292–307PubMedCrossRefGoogle Scholar
  11. [11]
    Green B., Duffull S.B., What is the best size descriptor to use for pharmacokinetic studies in the obese? Br. J. Clin. Pharmacol., 2004, 58(2), 119–133PubMedCentralPubMedCrossRefGoogle Scholar
  12. [12]
    Nam B.H., Kannel W.B., D’Agostino R.B., Search for an optimal atherogenic lipid risk profile: from the Framingham Study, Am. J. Cardiol., 2006, 97, 372–375PubMedCrossRefGoogle Scholar
  13. [13]
    Millán J., Pintó X., Muñoz A., Zúñiga M., Rubiés-Prat J., Pallardo L.F., Masana L., Mangas A., Hernandez-Mijares A., Gonzalez-Santos P., Ascaso J.F., Pedro-Botet J., Lipoprotein ratios: Physiological significance and clinical usefulness in cardiovascular prevention, Vasc. Health Risk Manag., 2009, 5, 757–765PubMedCentralPubMedGoogle Scholar
  14. [14]
    Kahn H.S., The Lipid Accumulation Product Is Better Than BMI for Identifying Diabetes. A population-based comparison, Diabetes Care, 2006, 29(1), 151–153PubMedCrossRefGoogle Scholar
  15. [15]
    McLaughlin T., Reaven G., Abbasi F., Lamendola C., Saad M., Waters D., Simon J., Krauss R.M., Is there a simple way to identify insulin-resistant individuals at increased risk of cardiovascular disease? Am. J. Cardiol., 2005, 96(3), 399–404PubMedCrossRefGoogle Scholar
  16. [16]
    Ruhl C.E., Everhart J.E., Association of diabetes, serum insulin, and C-peptide with gallbladder disease, Hepatology, 2000, 31(2), 299–303PubMedCrossRefGoogle Scholar
  17. [17]
    Tsai C.J., Leitzmann M.F., Willett W.C., Giovannucci E.L., Prospective study of abdominal adiposity and gallstone disease in US men, Am. J. Clin. Nutr., 2004, 80(1), 38–44PubMedGoogle Scholar
  18. [18]
    Chen L.Y., Qiao Q.H., Zhang S.C., Chen Y.H., Chao G.Q., Fang L.Z., Metabolic syndrome and gallstone disease, World J. Gastroenterol., 2012, 18(31), 4215–4220PubMedCrossRefGoogle Scholar
  19. [19]
    Sporea I., Goldis M., Mateoc A., Echographic screening concerning the incidence of gallstones in a general population, Gastroenterol., 1993, 104, A379Google Scholar
  20. [20]
    Acalovschi M., Pascu M., Iobagiu S., Petrescu M., Olinici C.D., Increasing gallstones prevalence and cholecystectomy rate in a large Romanian town, Dig. Dis. Sci., 1995, 40, 2582–2586PubMedCrossRefGoogle Scholar

Copyright information

© Versita Warsaw and Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Doina-Clementina Cojocaru
    • 1
    • 4
  • Florin Mitu
    • 1
    • 4
  • Cristina Gena Dascălu
    • 2
    • 4
  • Alina Manole
    • 3
    • 4
  • Corina Dima-Cozma
    • 1
    • 4
  1. 1.Ist Medical DepartmentFaculty of MedicineIasiRomania
  2. 2.Medical Informatics and Biostatistics DepartmentFaculty of Dental MedicineIasiRomania
  3. 3.Primary Health Care and Epidemiology DepartmentFaculty of MedicineIasiRomania
  4. 4.University of Medicine and Pharmacy “Grigore T. Popa”IasiRomania

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