Lai Shih-Wei, Liao Kuan-Fu, Lai Hsueh-Chou, Chou Che-Yi, Cheng Kao-Chi, Lai Yen-Miao
From the Department of Family Medicine (SWL, KCC, YML) and Department of Internal Medicine (KFL, HCL, CYC), China Medical University Hospital, Taichung, Taiwan.
Medicine (Baltimore). 2009 Jan;88(1):46-51. doi: 10.1097/MD.0b013e318194183f.
The pathogenesis of gallstone disease is multifactorial. Few studies have focused on gallbladder stones in the chronic kidney disease population in Taiwan. We conducted the current study to determine the prevalence of gallbladder stones in populations with and without chronic kidney disease.This was a hospital-based, cross-sectional study. We retrospectively analyzed the patients receiving periodic health examinations at 1 medical center in Taiwan from 2001 to 2004. In all, 4773 patients were enrolled in the study. Chronic kidney disease was defined as a glomerular filtration rate less than 60 mL/min per 1.73 m by the Modification of Diet in Renal Disease formula. Odds ratio (OR) and 95% confidence intervals (CI) were expressed using a multivariate logistic regression analysis.We studied 2686 men (56.3%) and 2087 women (43.7%). The mean age was 49.1 +/- 12.2 years (range, 20-87 yr). The prevalence of gallbladder stones was 13.1% in the group of patients with chronic kidney disease and 4.9% in the group of patients without chronic kidney disease (p < 0.001). After controlling for the other covariates, multivariate logistic regression analysis showed that increasing age (aged 40-64 yr vs. 20-39 yr, OR = 3.06, 95% CI = 1.81-5.15; and > or =65 yr vs. 20-39 yr, OR = 6.13, 95% CI = 3.42-10.98), chronic kidney disease (OR = 1.58, 95% CI = 1.01-2.47), body mass index > or =27 kg/m (OR = 1.39, 95% CI = 1.02-1.91), metabolic syndrome (OR = 1.45, 95% CI = 1.08-1.94), and cirrhosis (OR = 4.23, 95% CI = 1.25-14.29) were significantly related to gallbladder stone disease.The prevalence of gallbladder stones in patients with chronic kidney disease is significantly higher than in those without chronic kidney disease. Our findings suggest that increasing age, chronic kidney disease, body mass index > or =27 kg/m, metabolic syndrome, and cirrhosis are the related factors for gallbladder stone formation.
胆结石疾病的发病机制是多因素的。在台湾，很少有研究关注慢性肾脏病患者群体中的胆囊结石情况。我们开展了本研究以确定患慢性肾脏病和未患慢性肾脏病群体中胆囊结石的患病率。
这是一项基于医院的横断面研究。我们回顾性分析了2001年至2004年在台湾一家医疗中心接受定期健康检查的患者。总共4773名患者纳入研究。慢性肾脏病依据肾脏病饮食改良公式定义为肾小球滤过率低于每分钟60毫升/1.73平方米。比值比（OR）及95%置信区间（CI）采用多变量逻辑回归分析表示。
我们研究了2686名男性（56.3%）和2087名女性（43.7%）。平均年龄为49.1±12.2岁（范围20 - 87岁）。慢性肾脏病患者组中胆囊结石患病率为13.1%，未患慢性肾脏病患者组中为4.9%（p<0.001）。在控制其他协变量后，多变量逻辑回归分析显示，年龄增加（40 - 64岁 vs. 20 - 39岁，OR = 3.06，95%CI = 1.81 - 5.15；≥65岁 vs. 20 - 39岁，OR = 6.13，95%CI = 3.42 - 10.98）、慢性肾脏病（OR = 1.58，95%CI = 1.01 - 2.47）、体重指数≥27kg/m²（OR = 1.39，95%CI = 1.02 - 1.91）、代谢综合征（OR = 1.45，95%CI = 1.08 - 1.94）以及肝硬化（OR = 4.23，95%CI = 1.25 - 14.29）均与胆囊结石疾病显著相关。
慢性肾脏病患者中胆囊结石的患病率显著高于未患慢性肾脏病的患者。我们的研究结果表明，年龄增加、慢性肾脏病、体重指数≥27kg/m²、代谢综合征以及肝硬化是胆囊结石形成的相关因素。
