“ Risk Factor Assessment and Comorbidity Profile in Gallstone Disease: A Cross-Sectional Study in Uttarakhand, India
Gall stone disease and cormorbidity profile
Keywords:
Gall stone, Comorbidity, laproscopic cholecystectomyAbstract
Background: Gallstone disease (GSD) remains a major global health concern, typically benign but can lead to life-threatening complications. Risk factors such as advanced age, female gender, and overweight are well-established, yet gaps remain in understanding the regional epidemiology and associated comorbidities.
Aim & Objective: To explore the demographic and epidemiological patterns, assess risk factors, and evaluate comorbid conditions related to GSD.
Settings and Design: Cross-sectional study was conducted at a tertiary care hospital at Dehradun.
Methods and Material: The study was conducted among 233 patients who underwent laparoscopic cholecystectomy. Data was collected via patient interviews, medical records, and pathology reports.
Statistical analysis used: Mann-Whitney U tests for continuous variables and z-tests for proportions, with multilevel logistic regression used to identify predictors of symptomatic GSD.
Results: Out of the 233 participants, 143 were symptomatic and 88 were non-symptomatic. Symptomatic patients had significantly higher median BMI (p=0.021), waist circumference (p=0.014), systolic blood pressure (p=0.021), diastolic blood pressure (p=0.032), and insulin levels (p=0.004) compared to non-symptomatic patients. In multivariate analysis (Model 5), six significant covariates were identified: age (OR: 1.43, p<0.05), BMI (OR: 1.29, p<0.05), waist circumference (OR: 1.33, p<0.05), systolic blood pressure (OR: 1.27, p<0.05), insulin resistance (OR: 2.17, p<0.05), and the presence of comorbidities (OR: 2.41, p<0.05).
Conclusions: The study highlights that symptomatic GBD in Uttarakhand is strongly associated with higher BMI, waist circumference, insulin resistance, and multiple comorbidities. These findings underscore the importance of early intervention strategies targeting modifiable risk factors to reduce the burden of symptomatic GSD.
Key-words: Gallstone Disease, Insulin Resistance, Comorbidities, Body Mass Index (BMI), Laparoscopic Cholecystectomy
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References
A. Di Ciaula, G. Garruti, G. Frühbeck, M. De Angelis, O. de Bari, D.Q.-H. Wang, F. Lammert, P. Portincasa, The Role of Diet in the Pathogenesis of Cholesterol Gallstones, Curr Med Chem 26 (2019) 3620–3638. https://doi.org/10.2174/0929867324666170530080636.
L. Li, X. Qiao, X. Wang, D. Liu, Q. Xue, L. Han, F. Dai, G. Ma, Z. Yang, T. Zhang, S. Yang, S. Cai, M. Gao, J. Yang, The association between apolipoprotein E and gallstone disease: an updated meta-analysis, BMC Med Genet 20 (2019) 109. https://doi.org/10.1186/s12881-019-0843-6.
E.A. Shaffer, Gallstone disease: Epidemiology of gallbladder stone disease., Best Practice & Research. Clinical Gastroenterology 20 (2006) 981–996. https://doi.org/10.1016/j.bpg.2006.05.004.
L.M. Stinton, E.A. Shaffer, Epidemiology of gallbladder disease: Cholelithiasis and cancer, Gut and Liver 6 (2012). https://doi.org/10.5009/gnl.2012.6.2.172.
N.M. Parra-Landazury, N.M. Parra-Landazury, J. Córdova-Gallardo, J. Córdova-Gallardo, N. Méndez-Sánchez, N. Méndez-Sánchez, N. Méndez-Sánchez, Obesity and Gallstones, Visc Med (2021). https://doi.org/10.1159/000515545.
E.A. Shaffer, E.A. Shaffer, Epidemiology of gallbladder stone disease, Best Practice & Research in Clinical Gastroenterology (2006). https://doi.org/10.1016/j.bpg.2006.05.004.
L. Chen, L.-Y. Chen, Q.-H. Qiao, Q.-H. Qiao, S. Zhang, S.-C. Zhang, Y. Chen, Y.-H. Chen, G. Chao, G.-Q. Chao, L. Fang, L.-Z. Fang, Metabolic syndrome and gallstone disease., World J Gastroenterol (2012). https://doi.org/10.3748/wjg.v18.i31.4215.
Li, X. Qiao, X. Qiao, X. Wang, X. Wang, D. Liu, D. Liu, Q. Xue, Q. Xue, L. Han, L. Han, F. Dai, F. Dai, F. Dai, F. Dai, G. Ma, G. Ma, Z. Yang, Z. Yang, T. Zhang, T. Zhang, S. Yang, S. Yang, S. Cai, S. Cai, M. Gao, M. Gao, J. Yang, J. Yang, J. Yang, J. Yang, The association between apolipoprotein E and gallstone disease: an updated meta-analysis, BMC Med Genet (2019). https://doi.org/10.1186/s12881-019-0843-6.
G. Misciagna, G. Misciagna, S. Centonze, S. Centonze, C. Leoci, C. Leoci, C. Leoci, V. Guerra, V. Guerra, A.M. Cisternino, A.M. Cisternino, R. Ceo, R. Ceo, M. Trevisan, M. Trevisan, Diet, physical activity, and gallstones—a population-based, case-control study in southern Italy, Am J Clin Nutr (1999). https://doi.org/10.1093/ajcn/69.1.120.
G.D. Friedman, G.D. Friedman, G.D. Friedman, Natural history of asymptomatic and symptomatic gallstones, Am J Surg (1993). https://doi.org/10.1016/s0002-9610(05)80930-4.
P. Portincasa, P. Portincasa, A. Moschetta, A. Moschetta, G. Palasciano, G. Palasciano, Cholesterol gallstone disease, The Lancet (2006). https://doi.org/10.1016/s0140-6736(06)69044-2.
A.M. Patel, M. Yeola, C. Mahakalkar, Demographic and Risk Factor Profile in Patients of Gallstone Disease in Central India, Cureus (2022). https://doi.org/10.7759/cureus.24993.
R.K. Singh, S. Prakash, V. Vishal, S. Alok, STUDY OF CLINICAL PROFILE IN PATIENTS WITH SOLITARY VERSUS MULTIPLE GALL STONE DISEASE, International Journal of Academic Medicine and Pharmacy (Www.Academicmed.Org) Original Research Article Int J Acad Med Pharm 5 (2023) 1594–1598. https://doi.org/10.47009/jamp.2023.5.2.334.
A.K. Diehl, Epidemiology and natural history of gallstone disease, Gastroenterology Clinics of North America 20 (1991). https://doi.org/10.1055/s-2008-1040469.
T. Jørgensen, Gall stones in a Danish population: fertility period, pregnancies, and exogenous female sex hormones., Gut 29 (1988) 433–439. https://doi.org/10.1136/gut.29.4.433.
L.Y. Chen, Q.H. Qiao, S.C. Zhang, Y.H. Chen, G.Q. Chao, L.Z. Fang, Metabolic syndrome and gallstone disease, World Journal of Gastroenterology 18 (2012). https://doi.org/10.3748/wjg.v18.i31.4215.
D. Aune, T. Norat, L.J. Vatten, Body mass index, abdominal fatness and the risk of gallbladder disease, European Journal of Epidemiology 30 (2015). https://doi.org/10.1007/s10654-015-0081-y.
L.M. Stinton, L.M. Stinton, R.P. Myers, R.P. Myers, E.A. Shaffer, E.A. Shaffer, Epidemiology of Gallstones, Gastroenterol Clin North Am (2010). https://doi.org/10.1016/j.gtc.2010.02.003.
R.S. Sandler, R.S. Sandler, J.E. Everhart, J.E. Everhart, M. Donowitz, M. Donowitz, E. Adams, E. Adams, K. Cronin, K. Cronin, C. Goodman, C. Goodman, E. Gemmen, E. Gemmen, E. Gemmen, S.S. Shah, S. Shah, A. Avdic, A. Avdic, R. Rubin, R.J. Rubin, The burden of selected digestive diseases in the United States, Gastroenterology (2002). https://doi.org/10.1053/gast.2002.32978.
N. Méndez-Sánchez, N. Méndez-Sánchez, D. Zamora-Valdés, D. Zamora-Valdés, N.C. Chávez-Tapia, N.C. Chávez-Tapia, M. Uribe, M. Uribe, M. Uribe, Role of diet in cholesterol gallstone formation, Clinica Chimica Acta (2007). https://doi.org/10.1016/j.cca.2006.08.036.
L.M. Stinton, L.M. Stinton, E.A. Shaffer, E.A. Shaffer, Epidemiology of Gallbladder Disease: Cholelithiasis and Cancer, Gut Liver (2012). https://doi.org/10.5009/gnl.2012.6.2.172.
C.E. Ruhl, J.E. Everhart, Gallstone disease is associated with increased mortality in the United States, Gastroenterology 140 (2011). https://doi.org/10.1053/j.gastro.2010.10.060.
Y. Zhang, L. Sun, X. Wang, Z. Chen, The association between hypertension and the risk of gallstone disease: a cross-sectional study, BMC Gastroenterol 22 (2022) 138. https://doi.org/10.1186/s12876-022-02149-5.
C.-J. Tsai, M.F. Leitzmann, W.C. Willett, E.L. Giovannucci, Prospective study of abdominal adiposity and gallstone disease in US men, Am J Clin Nutr 80 (2004) 38–44. https://doi.org/10.1093/ajcn/80.1.38.
I.-C. Lin, Y.-W. Yang, M.-F. Wu, Y.-H. Yeh, J.-C. Liou, Y.-L. Lin, C.-H. Chiang, The association of metabolic syndrome and its factors with gallstone disease, BMC Fam Pract 15 (2014) 138. https://doi.org/10.1186/1471-2296-15-138.
F. Lammert, T. Sauerbruch, Mechanisms of disease: The genetic epidemiology of gallbladder stones, Nature Clinical Practice Gastroenterology and Hepatology 2 (2005). https://doi.org/10.1038/ncpgasthep0257.
Mathew G and Agha R, for the STROCSS Group. STROCSS 2021: Strengthening the Reporting of cohort, cross-sectional and case-control studies in Surgery. International Journal of Surgery 2021;96:106165.
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