Kratzer W, Kächele V, Mason R A, Hill V, Hay B, Haug C, Adler G, Beckh K, Muche R
Department of Internal Medicine, Institute for Clinical Chemistry, University of Ulm, Germany.
Dig Dis Sci. 1998 Jun;43(6):1285-91. doi: 10.1023/a:1018816109905.
The Ulm Gallbladder Stone Study is the first ultrasound-based epidemiologic survey of cholecystolithiasis in the former West Germany. A study population of 1116 blood donors (656 men, age 38.0 +/- 12.0 years; 460 women, age 34.1 +/- 11.2 years) at the Central Blood Bank of the German Red Cross in Ulm was examined between April 1994 and February 1995. Based on age, subjects were assigned to one of four groups (18-30, 31-40, 41-50, and 51-65 years). Following a structured interview of each study subject, an ultrasound examination was carried out and a blood sample obtained for laboratory study. Overall, 6.0% (95% (95% CI: 4.8%-7.6%) of all study subjects (5.8% of the men and 6.3% of the women) exhibited evidence of current or past gallbladder disease (cholelithiasis or history of cholecystectomy). The prevalence of gallbladder disease correlated positively with age, reaching a maximum of 13.7% (9.5-20.0) in the 51- to 65-year-old age group, and also correlated as with body mass index (BMI). Female subjects with previous full-term pregnancies showed a higher prevalence of cholelithiasis, but this difference was not statistically significant for age-adjusted analysis. Subjects with a family history of cholelithiasis were found to suffer from gallstones in 11.5% (8.0-16.7) of cases compared with 4.6% (3.4%-6.3%) of subjects without such family history. Autopsy studies conducted in Germany have shown the prevalence of gallstones to be about 13.1% in men and 33.8% in women. Our sonographic data are relatively low in comparison. This may be due, in part, to the specific selection characteristics inherent in retrospective autopsy studies, such as age distribution and the presence of other pathologic factors associated with increased risk for cholelithiasis. The Ulm data rank in the lower third of the prevalence range reported for European sonographic studies to date. Age, positive family history, and increased BMI all correlated positively with the prevalence of gallbladder disease (P < 0.05). For the study population as a whole, there was no gender-specific increased risk for the development of gallstones.
乌尔姆胆结石研究是在前西德进行的首次基于超声的胆囊结石病流行病学调查。1994年4月至1995年2月期间，对乌尔姆德国红十字会中央血库的1116名献血者（656名男性，年龄38.0±12.0岁；460名女性，年龄34.1±11.2岁）进行了研究。根据年龄，受试者被分为四组之一（18 - 30岁、31 - 40岁、41 - 50岁和51 - 65岁）。在对每个研究对象进行结构化访谈后，进行了超声检查并采集了血样用于实验室研究。总体而言，所有研究对象中有6.0%（95%置信区间：4.8% - 7.6%）（男性为5.8%，女性为6.3%）有当前或过去胆囊疾病（胆结石或胆囊切除术史）的证据。胆囊疾病的患病率与年龄呈正相关，在51至65岁年龄组中达到最高值13.7%（9.5 - 20.0），并且也与体重指数（BMI）相关。有过足月妊娠史的女性受试者胆结石患病率较高，但在年龄调整分析中，这种差异无统计学意义。有胆结石家族史的受试者中，11.5%（8.0 - 16.7）患有胆结石，而无此类家族史的受试者中这一比例为4.6%（3.4% - 6.3%）。在德国进行的尸检研究表明，男性胆结石患病率约为13.1%，女性为33.8%。相比之下，我们的超声检查数据相对较低。这可能部分归因于回顾性尸检研究固有的特定选择特征，如年龄分布以及与胆结石风险增加相关的其他病理因素的存在。乌尔姆的数据在欧洲迄今为止报道的超声研究患病率范围的下三分之一。年龄、阳性家族史和BMI增加均与胆囊疾病患病率呈正相关（P < 0.05）。对于整个研究人群，胆结石形成没有性别特异性的风险增加。
