Abstract
A study was undertaken to compare the prevalence of gallstone disease (gallstones observed on ultrasound or history of cholecystectomy) in 308 diabetics and 318 controls. There was a higher prevalence of gallstone disease (GSD) in diabetics (32.7%) compared to controls (20.8%;P<0.001 chi-squared test). However, when gender was taken into account, the difference was only significant in females (diabetics 41.8% versus controls 23.1%;P<0.001). Analysis by type of diabetes revealed that subjects with non-insulin-dependent diabetes mellitus (NIDDM) had a higher prevalence of GSD than controls for both genders: males—controls 18.1%, NIDDM 33.3% (P<0.05), IDDM 15.6% ns; females—controls 23.1%, NIDDM 48.6% (P<0.001), IDDM 36.3% (P<0.05). On univariate analysis the following risk factors were associated with gallstones (P<0.1): increased age, body mass index (BMI), triglycerides, LDL cholesterol, decreased HDL cholesterol, alcohol intake, family history of GSD, and female parity >3. Using stepwise multiple logistic regression, the following variables were identified as independently predictive of gallstones for each gender/diabetic combination: Males—NIDDM (N=54), increased age, and decreased HDL; IDDM (N=90), age and family history; Females—NIDDM (N=74), increased age, diabetes, increased BMI, and decreased alcohol; IDDM (N=91), increased BMI, age, decreased alcohol and family history. The proportion of subjects who underwent cholecystectomy was higher in females (46.7%) compared to males (21.7%;P<0.01) but there were no differences between diabetics and controls in either sex. In conclusion, there was a higher prevalence of GSD in diabetics compared to controls. However, GSD is multifactorial and only in NIDDM females was diabetes an independent risk factor. The proportion of diabetics and controls with GSD who underwent cholecystectomy was equivalent.
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Jorgensen T: Prevalence of gallstones in a Danish population. Am J Epidemiol 126:912–921, 1987
Jorgensen T, Kay L, Schultz-Larsen K: The epidemiology of gallstones in a 70-year-old Danish population. Scand J Gastroenterol 25:335–340, 1990
Diehl AK: Epidemiology and natural history of gallstone disease. Gastroenterol Clin North Am 20:1–19, 1991
Sama C, Labate AMM, Taroni F, Barbara L: Epidemiology and natural history of gallstone disease. Semin Liver Dis 10:149–169, 1990
Warren S: The Pathology of Diabetes Mellitus, 2nd ed. Philadelphia, Lea & Febiger, 1938, pp. 106, 246
Lieber MM: The incidence of gallstones and their correlation with other diseases. Ann Surg 135:394–405, 1952
Newman HF, Northup JD: The autopsy incidence of gallstones. Int Abstr Surg 109:1–13, 1959
Feldman M, Feldman M Jr: The incidence of cholelithiasis, cholesterosis, and liver disease in diabetes mellitus: An autopsy study. Diabetes 3:305–307, 1954
Zahor Z, Sternby NH, Kagan A, Uemura K, Vanecek R, Vichert AM: Frequency of cholelithiasis in Prague and Malmo, an autopsy study. Scand J Gastroenterol 9:3–7, 1974
Diehl AK, Stern MP, Ostrower VS, Friedman PC: Prevalence of clinical gallbladder disease in Mexican-American Anglo and black women. South Med J 73:438–443, 1990
Lu S-N, Chang W-Y, Wang L-Y, Hsieh M-Y, Chuang W-L, Chen S-C, Su W-P, Tai T-Y, Wu M-M, Chven C-J: Risk factors for gallstones among Chinese in Taiwan. A community sonographic survey. J Clin Gastroenterol 12:542–546, 1990
Diehl AK, Haffner SM, Hazuda HP, Stern MP: Coronary risk factors and clinical gallbladder disease. An approach to the prevention of gallstones? Am J Public Health 77:841–845, 1987
Friedman GD, Kannel WB, Dawber TR: The epidemiology of gallbladder disease: Observations in the Framingham Study. J Chron Dis 19:273–292, 1966
Sampliner RF, Bennett PH, Comess J, Rose FA, Burch TA: Gallbladder disease in Pima Indians: Demonstration of high prevalence and early onset by cholecystography. N Engl J Med 283:1358–1364, 1970
Honare LH: The lack of a positive association between symptomatic cholelithiasis and clinical diabetes mellitus: A retrospective study. J Chron Dis 33:465–469, 1985
Barbara L, Sama C, Labate AMM, Taroni F, Rusticali AG, Festi D, Sapio C, Roda E, Banterle C, Puci A, Formentini F, Colasanti NF, Nardin F: A population study on the prevalence of gallstone disease: The Sirmione Study. Hepatology 7:913–917, 1987
Grepco Study: The epidemiology of gallstone disease in Rome, Italy. Part I. Prevalence data in men. Part II. The epidemiology of gallstone disease in Rome, Italy. Hepatology 8:904–906, 1988
Jorgensen T: Gallstones in a Danish population. Relation to weight, physical activity, smoking, coffee consumption, and diabetes mellitus. Gut 30:528–534, 1989
Mauer KR, Everhart JE, Knowler WC, Shawker TH, Roth HP: Risk factors for gallstone disease in the Hispanic population of the United States. Am J Epidemiol 131:836–844, 1990
Janatuinen E, Pikkarainen Laakso M, Pyorala K: Gastrointestinal symptoms in middle-aged diabetic patients. Scand J Gastroenterol 28:427–432, 1993
Bartoli E, Ferrari E, Saporetti N, Rossi L: Prevalence of cholelithiasis in diabetes mellitus: A cholecystosonographic study. RAYS 12:43–46, 1987
Hayes PC, Patrick A, Roulston JE, Murchison J, Allan P, Plevris JN, Clarke BE, Bouchier IAD: Gallstones in diabetes mellitus: prevalence and risk factors. Eur J Gastroenterol Hepatol 4:55–59, 1992
De Santis A, De Luca C, Cantagalli A, Capri R, Porto D, Scafato E, Attili AF: The diabetes-cholelithiasis association in a case-control study. Ital J Gastroenterol 20:158–159, 1988
Haffner SM, Diehl AK, Mitchell BD, Stern MP, Hazuda HP: Increased prevalence of clinical gallbladder disease in subjects with non-insulin-dependent diabetes mellitus. Am J Epidemiol 132:327–335, 1990
Persson GE, Thulin AJG: Prevalence of gallstone disease in patients with diabetes mellitus. Eur J Surg 157:579–582, 1991
National Diabetes Data Group: Classification and diagnosis of diabetes mellitus and other categories of glucose intolerance. Diabetes 28:1039–1057, 1979
Wilkinson L: SYSTAT—The System for Statistics. Evanston Illinois, 1992
Ponz de Leon M, Ferenderes R, Carulli N: Bile lipid composition and bile acid pool size in diabetes. Am J Dig Dis 23:710–716, 1978
Stone BG, Gavaler JS, Belle SH, Shreiner DP, Peleman RR, Sarva RP, Yingvorapant N, Van Thiel DH: Impairment of gallbladder emptying in diabetes mellitus. Gastroenterology 95:170–176, 1978
Schreiner DP, Sarva RP, Van Thiel D, Yingvorapant N: Gallbladder function in diabetic patients. J Nucl Med 27:357–360, 1986
Scragg RR, Calvert DG, Oliver JR: Plasma lipids and insulin in gallstone disease: A case-control study. BMJ 289:521–525, 1984
Laakso M, Suhonen M, Julkunen R, Pyorola K: Plasma insulin, serum lipids and lipoproteins in gallstone disease in non-insulin dependent diabetic subjects: A case control study. Gut 31:344–347, 1990
Turrill FL, McCarron MM, Mikkelsen WP: Gallstones and diabetes: An ominous association. Am J Surg 102:184–190, 1961
Mundth ED: Cholecystitis and diabetes mellitus. N Engl J Med 267:642–646, 1962
Ransohoff DF, Miller GL, Forsythe SB, Hermann RE: Outcome of cholecystitis in patients with diabetes mellitus. Ann Intern Med 106:829–832, 1987
Friedman LS, Roberts MS, Brett AS, Marton KI: Management of asymptomatic gallstones in the diabetic patient. Ann Intern Med 109:913–919, 1988
Aucott JN, Cooper GS, Bloom AD, Aron DC: Management of gallstones in diabetic patients. Arch Intern Med 153:1053–1058, 1993
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Chapman, B.A., Wilson, I.R., Frampton, C.M. et al. Prevalence of gallbladder disease in diabetes mellitus. Digest Dis Sci 41, 2222–2228 (1996). https://doi.org/10.1007/BF02071404
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DOI: https://doi.org/10.1007/BF02071404