Factors associated with gallstone disease in the MICOL experience

Abstract

The epidemiological associations of gallstone disease were by age and sex have been extensively reported in a previous article, 1 and will be only briefly recalled here. This article evaluated in a general population sample of 29,584 individuals (15,910 men and 13,674 women; age range, 30-39 years) analyzes and discusses the relationships between gallstone disease and the associated individual factors. belonging to 14 cohorts examined between December 1984 and April 1987. Subjects were screened for the presence of PATIENTS AND METHODS gallstones by gallbladder ultrasonography, completed a questionnaire, and underwent a physical examination and blood Data Collection. The study protocol was prepared by the coordichemistry tests. Participants were considered to have gall-nating unit based on experience gained during the pioneering epidestone disease if they had already had cholecystectomy or gall-miological studies performed in Italy by the Rome Group for the stones. Statistical associations were established by univariate Epidemiology and Prevention of Cholelithiasis (GREPCO) 2-5 and analysis of the age-standardized data and by stepwise multiple the Sirmione project. 6 The examination included an interview with logistic regression. Increasing age and body mass index and the administration of a standard questionnaire, followed by a physia maternal family history of gallstone disease were the most cal and ultrasonographic examination of the upper abdomen and a blood sampling for biochemical analyses. Field activities started in consistent associations (both at univariate and multivariate were associated with gallstone disease in both sexes in the If not, have you ever smoked regularly? 3) Have you ever suffered multivariate analysis. In women, associations were also found from diabetes, gastric or duodenal ulcer, myocardial infarction or with a number of pregnancies and paternal family history angina, hepatic cirrhosis, Crohn's disease, or hemolytic anemia? of gallstone disease. A slight but negative association with 4) Have you ever regularly assumed serum lipid-lowering drugs, contraceptive pill use was identified only at multivariate anal-aspirin, or antirheumatic drugs? If yes, which and for how long? and 5) Have you ever been on a slimming diet? Women were also ysis. Associations (investigated at univariate analysis) were asked about the number of pregnancies and use of estroprogestinic also found with diabetes, cirrhosis, angina or myocardial indrugs. To estimate the prevalence of gallstone disease, the final farction, and peptic ulcer. There was no association with gallbladder status was recorded as follows: 1) normal at ultrasonogsmoking habits and use of aspirin or antirheumatic drugs. raphy; 2) presence of gallstones at ultrasonography; 3) presence of (HEPATOLOGY 1997;26:809-818.) biliary sludge at ultrasonography; 4) previous cholecystectomy; and 5) inconclusive or doubtful. Gallstone disease was defined as the presence of conditions 2 or 4. A blood sample was obtained fromThe MICOL study (Multicenter Ital...

Diet and gallstones in italy: The cross-sectional MICOL results

“…A decreasing risk of GS and increasing serum HDL cholesterol levels are observed by increasing daily wine consumption. Although the association of GS with HDL cholesterol levels reported in some articles [73][74][75] does not seem to be independent, 37,52,57 our observations support the hypothesis that alcohol protects against GS formation by increasing serum HDL cholesterol levels. Other mechanisms cannot be excluded.…”

“…This association was suggested in the past, 76 but never demonstrated in an epidemiological study. We previously demonstrated in the same population 37 that slimming diets are a risk factor for GS. These observations confirm that fasting and gallbladder contraction are key factors in the pathogenesis of GS.…”

“…52 GS disease is associated with diabetes. 37,[53][54][55][56][57][58] Supersaturation of bile with cholesterol 59,60 and an impaired gallbladder contraction 61 are frequent in diabetic subjects. Scragg reported a positive association with refined sugar, but not with total carbohydrates.…”

“…The study protocol has been described in detail elsewhere. 36,37 In brief, field activities started in December 1984 and finished in April 1987. Subjects enrolled in the study, ranging from 30 to 69 years of age, were selected on the basis of electoral roles in 18 operative units, of which 4 were excluded because of a low participation rate.…”

Apolipoprotein E genotype and the risk of gallbladder disease in pregnancy

“…Previous studies have identified this association with prevalent stones. 31,33 In contrast, although higher parity is a risk factor for prevalent stones in women, 31,34 we did not confirm that parity is a risk factor for incident sludge during pregnancy. It is likely that the higher prevalence of gallstones in multiparous women is caused by the multiple ''high-risk'' periods of pregnancy during which gallstones can form.…”