在印度北部恒河流域农村进行基于人群的研究，估计胆囊疾病的患病率并确定其危险因素。
Population-based study to estimate prevalence and determine risk factors of gallbladder diseases in the rural Gangetic basin of North India.
机构信息
Department of Mathematical Demography and Statistics, International Institute of Population Sciences, Mumbai, India.
出版信息
HPB (Oxford). 2011 Feb;13(2):117-25. doi: 10.1111/j.1477-2574.2010.00255.x. Epub 2010 Dec 22.
BACKGROUND
A high prevalence of gallbladder diseases (GBD) in Northern India warranted a population survey into environmental risk factors.
METHODS
In 60 villages of Uttar Pradesh and Bihar from 13 334 households, 22 861 persons aged >30 years were interviewed for symptoms of GBD, diet and environmental factors. Subsequently ultrasonography (US) was performed in 5100 and 1448 people with and without symptoms, respectively. Heavy metal and pesticide content in soil and water were estimated.
RESULTS
US revealed a prevalence of GBD of 6.20%. GBD was more common in 5100 persons with symptoms (7.12%) compared with 1448 without (2.99%) (P < 0.05). Adjusted odds ratio (ORs) [95% confidence interval (CI)] revealed a significantly increased risk of GBD in females >50, 1.703 (CI 1.292-2.245); multiparity 1.862 (CI 1.306-2.655) and a genetic history 1.564 (CI 1.049-2.334). An increased risk noted in males with diabetes was 4.271 (CI 2.130-8.566), chickpea consumption 2.546 (CI 1.563-4.146) and drinking unsafe water 3.835 (CI 2.368-6.209). Prevalence of gallstones was 4.15%; more in females 5.59% than males 1.99% (P < 0.05). Cluster analysis identified a positive correlation of nickel, cadmium and chromium in water with a high prevalence of GBD in adjacent villages in Vaishali district, Bihar.
CONCLUSION
A high risk of GBD was observed in older, multiparous women and men with diabetes, intake of chickpeas, unsafe water and villages with heavy metal water pollution.
背景
在印度北部，胆囊疾病（GBD）的高发率使得对环境危险因素进行人群调查成为必要。
方法
在北方邦和比哈尔邦的 60 个村庄的 13334 户家庭中，对年龄>30 岁的 22861 人进行了 GBD 症状、饮食和环境因素的调查。随后，对有症状和无症状的 5100 人和 1448 人分别进行了超声检查（US）。评估了土壤和水中重金属和农药的含量。
结果
US 显示 GBD 的患病率为 6.20%。在有症状的 5100 人中，GBD 的患病率为 7.12%，而无症状的 1448 人中，GBD 的患病率为 2.99%（P<0.05）。调整后的比值比（OR）[95%置信区间（CI）]显示，50 岁以上的女性（OR=1.703，CI=1.292-2.245）、多产（OR=1.862，CI=1.306-2.655）和遗传史（OR=1.564，CI=1.049-2.334）的 GBD 风险显著增加。在男性中，糖尿病的风险增加了 4.271（CI=2.130-8.566），食用鹰嘴豆增加了 2.546（CI=1.563-4.146），饮用不安全的水增加了 3.835（CI=2.368-6.209）。胆结石的患病率为 4.15%；女性患病率为 5.59%，高于男性的 1.99%（P<0.05）。聚类分析发现，比哈尔邦 Vaishali 区相邻村庄的水中镍、镉和铬含量与 GBD 的高患病率呈正相关。
结论
年龄较大、多产的女性、糖尿病男性、食用鹰嘴豆、饮用不安全的水和受重金属水污染的村庄，其 GBD 风险较高。
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