Spathis A, Heaton K W, Emmett P M, Norboo T, Hunt L
Department of Medicine, Addenbrooke's Hospital, Cambridge, UK.
Eur J Gastroenterol Hepatol. 1997 Feb;9(2):201-6. doi: 10.1097/00042737-199702000-00018.
To verify anecdotal reports that gallstones were frequent in a remote community where obesity is rare and to look for possible explanations of their occurrence, including slow intestinal transit.
Population survey of gallbladder status and stool form.
Two villages in Ladakh, a mountainous region of northern India; for comparison, a stratified random sample from general practitioners' lists in East Bristol.
Women aged 25-59 years, 437 in Ladakh and 974 in Bristol.
Presence of gallstones on ultrasonography and response to questionnaires about parity, the intake of dried legume seeds (pulses) and bowel function including the form or appearance of the stools on a seven-point, transit-sensitive scale. Weight, height and waist circumference were also recorded.
Gallstone disease was at least as frequent in Ladakh as in Bristol although Ladakhi women were uniformly slim and their weight, waist size and body mass index failed to rise with age. After adjustment for age, gallstone disease was associated with higher body mass index and waist size in Bristol but not in Ladakh. It was associated with increased parity in Bristol, but not significantly so after adjusting for age and not at all in Ladakh. Gallstone disease was not directly associated with bowel function but Ladakhis often reported their stools to be lumpy (42.4 vs. 26.5% of Bristol women) and seldom as soft or loose (6.4 vs. 42.5%), implying that their intestinal transit tends to be slow.
Gallstones can be common in a population free of obesity but prone to intestinal stasis.
核实关于在一个肥胖罕见的偏远社区胆结石频发的传闻报道，并寻找其发生的可能解释，包括肠道蠕动缓慢。
胆囊状况和粪便形态的人群调查。
印度北部山区拉达克的两个村庄；作为对照，从东布里斯托尔全科医生名单中选取的分层随机样本。
年龄在25至59岁之间的女性，拉达克有437名，布里斯托尔有974名。
超声检查发现胆结石情况，以及关于生育情况、干豆类种子（豆类）摄入量和肠道功能的问卷调查结果，包括用七点、对蠕动敏感的量表评估粪便的形态或外观。还记录了体重、身高和腰围。
拉达克的胆结石疾病发生率至少与布里斯托尔一样高，尽管拉达克女性普遍苗条，她们的体重、腰围和体重指数并未随年龄增长而上升。在调整年龄后，布里斯托尔的胆结石疾病与较高的体重指数和腰围相关，而拉达克并非如此。在布里斯托尔，胆结石疾病与生育次数增加相关，但在调整年龄后无显著相关性，在拉达克则完全无关。胆结石疾病与肠道功能无直接关联，但拉达克人常称他们的粪便呈块状（42.4%，而布里斯托尔女性为26.5%），很少呈软便或稀便（6.4%，而布里斯托尔女性为42.5%），这意味着他们的肠道蠕动往往较慢。
在一个没有肥胖但易发生肠道淤滞的人群中，胆结石可能很常见。
