Chen C Y, Lu C L, Lee P C, Wang S S, Chang F Y, Lee S D
Department of Medicine, Veterans General Hospital-Taipei and National Yang-Ming University School of Medicine, Taipei, Taiwan.
Hepatogastroenterology. 1999 May-Jun;46(27):1607-12.
BACKGROUND/AIMS: 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.
背景/目的：西方针对老年人胆结石疾病（GSD）危险因素的研究较少。尚不清楚这些因素在东方人群中是否也存在。因此，我们研究了台湾老年人中GSD的患病率及危险因素。
对在本院接受有偿体检的1441名老年受试者（≥60岁）进行调查。记录并比较他们的人口统计学特征和生化参数。超声诊断显示，1092名受试者胆囊正常，171名有胆囊结石，65名因胆结石行胆囊切除术，83名有胆囊息肉，10名有胆囊结石/息肉混合情况，20名结果异常。我们将236名有胆囊结石或因胆结石行胆囊切除术的受试者纳入GSD组。
排除胆囊结石/息肉混合情况的受试者后，我们研究系列中GSD的总体患病率为16.6%。多因素分析显示，GSD发生风险的相关因素为高龄（p<0.001）、血清高密度脂蛋白水平较低（p<0.01）、糖尿病（校正比值比：2.127；p<0.001）和糖耐量异常（校正比值比：1.954；p<0.001），而既往饮酒史（校正比值比：0.335；p<0.01）对GSD的发生有保护作用。其他人口统计学特征和生化参数，如体重指数、ABO血型、吸烟、血压、血清胆固醇水平、乙肝病毒携带者、肝功能和生育情况，与GSD均无相关性。
在台湾老年人群中，高龄、血清高密度脂蛋白水平较低、糖尿病和糖耐量异常的个体发生GSD的风险较高。
