The risk factors for gallstone disease among senior citizens: an Oriental study

Few Occidental studies have addressed the risk factors for gallstone disease (GSD), among aged people. It is unknown whether these factors also present in the Orientals. Therefore, we studied the prevalence and risk factors for GSD among aged people in Taiwan.

1441 aged subjects (> or = 60 years) who received a paid physical checkup at this hospital were investigated. Their demographic characteristics and biochemical parameters were recorded and compared. Ultrasonographic diagnosis revealed a normal gallbladder in 1092 subjects, gallbladder stones in 171, cholecystectomy for gallstones in 65, gallbladder polyps in 83, mixed gallbladder stones/polyps in 10, and miscellaneous results in 20. We enrolled 236 subjects showing either gallbladder stones or cholecystectomy for gallstones as the GSD group.

Excluding those subjects with mixed gallbladder stones/polyps, the overall prevalence of GSD in our series was 16.6%. Using multivariate analysis, the encountered factors manifesting risk for the development of GSD were old age (p<0.001), lower serum high-density lipoprotein level (p<0.01), diabetes mellitus (adjusted odds ratio: 2.127; p<0.001) and glucose intolerance (adjusted odds ratio: 1.954; p<0.001), whereas past history of alcohol consumption (adjusted odds ratio: 0.335; p<0.01) exhibited a protective effect against the development of GSD. Other demographic characteristics and biochemical parameters, such as body mass index, ABO blood type, cigarette smoking, blood pressure, serum cholesterol level, hepatitis B virus carrier, liver function, and parity, did not have any correlation to GSD.

Among the aged senior citizens in Taiwan, individuals with old age, lower serum high-density lipoprotein level, diabetes and glucose intolerance are at high risk for developing GSD.