Song Yang, Ma Yuan, Xie Fu-Cun, Jin Cheng, Yang Xiao-Bo, Yang Xu, Long Jun-Yu, Wang Dong-Xu, Sang Xin-Ting, Li Li-Ming, Zhao Hai-Tao, Ning Yi
Department of Liver Surgery, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.
Peking University Health Science Center, Meinian Public Health Institute, Beijing, China.
Ann Transl Med. 2022 Jul;10(13):735. doi: 10.21037/atm-21-6186.
The etiology of gallstones at different anatomical locations may be varied. However, it has not been well studied about the prevalence of gallstones by anatomical locations and their associated factors in China.
We used the data set from preventive health screening centers covering all provinces in mainland China except for Tibet, and a total of 10,937,993 adults were included, who received abdominal ultrasonography in 2017. We analyzed the prevalence of gallstones classified by anatomical locations, including gallbladder (GB) stones, intrahepatic bile duct (IHD) stones, and extrahepatic bile duct (EHD) stones. Further, their associated factors were investigated using a logistic regression model with body mass index (BMI), fasting glucose, total triglyceride, and previous cholecystectomy, with covariates of age and sex.
The age- and gender-standardized prevalence (AGS-prevalence) of gallstone diseases was 5.13% (95% CI: 5.11-5.14%). GB, IHD, and EHD stones accounted for 76.3%, 24.3%, and 0.2% of all gallstone cases (concomitant cases were present). GB, IHD, and EHD gallstones presented different patterns by the age, gender, geographic and metabolic factors. Overall, the age-standardized prevalence was higher in women than that in men (5.41% vs. 4.85%, P<0.001). The gender standardized prevalence of all gallstone subtypes apparently increased with age (P<0.001), especially for GB stones from 1.05% (age 18-30) to 11.6% (age ≥70) (P<0.001). There was a marked geographic variation with AGS-prevalence ranging from 3.00% to 8.86% among different provinces. Noticeably, higher BMI, fasting glucose level, or total triglyceride level was associated with a higher prevalence of overall gallstones and GB stones (OR >1), but associated with a lower prevalence of IHD and EHD stones.
The prevalence of gallstones in China largely varied in its anatomical location, demographic factors, geographic location, and metabolic factors, suggesting that the etiology of each subtype may be different. Further investigation should be conducted.
不同解剖部位胆结石的病因可能有所不同。然而，在中国，按解剖部位划分的胆结石患病率及其相关因素尚未得到充分研究。
我们使用了来自中国大陆除西藏外所有省份预防性健康筛查中心的数据集，共纳入10937993名成年人，他们于2017年接受了腹部超声检查。我们分析了按解剖部位分类的胆结石患病率，包括胆囊（GB）结石、肝内胆管（IHD）结石和肝外胆管（EHD）结石。此外，使用逻辑回归模型研究其相关因素，模型纳入体重指数（BMI）、空腹血糖、总甘油三酯和既往胆囊切除术，并将年龄和性别作为协变量。
胆结石疾病的年龄和性别标准化患病率（AGS患病率）为5.13%（95%CI：5.11 - 5.14%）。GB、IHD和EHD结石分别占所有胆结石病例（存在合并病例）的76.3%、24.3%和0.2%。GB、IHD和EHD胆结石在年龄、性别、地理和代谢因素方面呈现出不同模式。总体而言，女性的年龄标准化患病率高于男性（5.41%对4.85%，P<0.001）。所有胆结石亚型的性别标准化患病率均随年龄明显增加（P<0.001），尤其是GB结石从1.05%（18 - 30岁）增至11.6%（≥70岁）（P<0.001）。不同省份的AGS患病率存在显著地理差异，范围从3.00%至8.86%。值得注意的是，较高的BMI、空腹血糖水平或总甘油三酯水平与总体胆结石和GB结石的较高患病率相关（OR>1），但与IHD和EHD结石的较低患病率相关。
中国胆结石的患病率在解剖部位、人口统计学因素、地理位置和代谢因素方面差异很大，这表明各亚型的病因可能不同。应进行进一步调查。
