Gallstones and diabetes: A case-control study in a free-living population sample

Abstract

Data on the association between cholelithiasis and diabetes often are controversial and are mostly based on autopsies or on hospital series. Therefore, we designed a case-control study to determine the prevalence of diabetes mellitus in a group of subjects with gallstones or having undergone cholecystectomy (cases) and compared these with a control group of subjects without gallstones, selected during an epidemiological study performed on a free-living population sample. The subjects were matched for sex, age, and body mass index. We enlisted 336 cases and 336 controls, aged 30 to 69 years. All subjects with fasting glycemic levels of < 140 mg/dL and without a documented history of diabetes were submitted to a simplified oral glucose tolerance test (OGTT). All subjects who underwent OGTT were classified according to the National Diabetes Data Group (NDDG) criteria. The prevalence of diabetes in the subjects affected by gallstone disease was significantly higher than that in controls (11.6% vs. 4.8%; odds ratio [OR], 2.55; 95% confidence interval [CI], 1.39-4.67). Diabetes was more frequent in subjects with gallstone disease than in the control group, even according to sex (18.3% vs. 9.9% for men: OR, 2.03; 95% CI, 0.99-4.2; 9.3% vs. 2.6% for women: OR, 3.85; 95% CI, 1.4-10.6). We conclude that an altered glucose metabolism may increase the risk of developing cholelithiasis in certain subjects.

Clinical correlation of gallstone disease in a Chinese population in Taiwan: Experience at Cheng Hsin General Hospital

“…Such a finding is consistent with results of other hospital-based and community-based studies conducted elsewhere [2][3][4][5]7,8] . GSD is very seldom found in children, and in that age group is mainly associated with haemolytic causes [15] .…”

“…In the present study, GSD appeared to be fairly common for the test population, affecting an estimated 5.3% of the general population in Taiwan. The prevalence of GSD amongst different test populations appears to vary, differing among different studies conducted in different countries [1,[3][4][5][6] . In addition to different methods of GSD assessment, this disparity might be due to differences between different population stocks.…”

“…Recent studies indicate varying prevalence of GSD with several predisposing factors in different study populations [1][2][3][4][5][6][7][8][9] . From a medical economic perspective, the direct and indirect costs of treating GSD patients were estimated at $16 billion and account for more than 800 000 hospitalizations yearly in the United States [9,10] .…”

“…Although most epidemiologic studies of GSD, demographic factors and biochemical markers have used case-control designs and cross-sectional data [1][2][3][4][5][6][7][8][9] , to the best of our knowledge, some uncertainty still exists regarding the prevalence of the disease and the identity of the associated risk factors for the development of GSD. The present study was designed to explore potential associated risk factors and to improve understanding of the overall pathogenesis of GSD.…”

Association of diabetes, serum insulin, and c-peptide with gallbladder disease

“…An association of oral cholecystography or ultrasound-documented gallbladder disease with diabetes mellitus was found in some [2][3][4][5][6][7][8] but not all [9][10][11] population-based epidemiological studies, and the strength of its association varied markedly across studies. Although the negative findings of some studies may have been because of limitations in design or statistical power, another possible explanation for this variation is that the insulin resistance that characterizes most persons who develop non-insulin-dependent diabetes mellitus may be a primary factor involved in gallstone formation.…”