The epidemiology of gallstone disease in Rome, Italy. Part II. Factors associated with the disease


  • Members of the Rome Group for Epidemiology and Prevention of Cholelithiasis are: Policy board—L. Capocaccia, G. Giunchi, F. Pocchiari and G. Ricci. Steering committee—F. Angelico, M. Angelico and A. F. Attili. Coordination—M. Arca, P. Clemente, A. De Santis, L. Lalloni, G. Morisi and G. C. Urbinati. Clinical Staff—D. Alvaro, L. Antonaci, A. Calvieri, S. Cocca, A. De Santis and E. Scafato. Ultrasonographic and radiologic staff—R. Conti, L. Lalloni, F. Mariucci and P. Ricci. Biochemical staff—D. Alvaro, R. Antonini, A. Buongiorno, S. Ciocca, B. Mazzarella, A. Montali, G. Morisi and U. Pieche. Biostatistical staff—M. Arca, R. Capocaccia and A. Menotti. Editorial board—F. Angelico, M. Angelico, A. F. Attili, L. Capocaccia, L. Lalloni and G. Ricci.

Abstract

The epidemiological associations of gallstone disease were evaluated in a population of 2,325 civil servants (1,244 men and 1,081 women) in Rome, Italy, which was enrolled in a cross-sectional survey on cholelithiasis. Participants were screened for the presence of gallstones by gallbladder ultrasonography, completed a questionnaire on family and personal history and underwent a physical examination and blood chemistry. Statistically significant associations were established by univariate analysis of the age-standardized data and by step-wise multiple logistic regression.

At univariate analysis, increasing age, serum triglycerides and number of cigarettes smoked per day, and decreasing high-density lipoprotein-cholesterol were the conditions associated with the presence of gallstones in men. Age and parity were the correspondent associations in women. After controlling by multiple logistic regression, a different pattern of associated conditions emerged. In men, only age and serum triglycerides showed a significant positive association with gallstones, which was independent of other variables. In women, the presence of gallstones was independently associated with increasing age, number of pregnancies, body mass index and serum triglycerides, and with decreasing total (and low-density lipoprotein) cholesterol. The latter association was curvilinear in shape.

The conditions associated with a history of cholecystectomy differed from those observed in subjects with gallstones, with the exceptions of age, in both sexes, and high serum triglycerides, in women. Fasting blood glucose levels were higher in women with a history of cholecystectomy than in those with or without gallstones, both at univariate and multiple logistic regression analyses.

The ongoing prospective evaluation of the populations under study will elucidate the potential role of the epidemiological associations found in men and women as risk factors for the development of gallstones.

Ancillary