The aim of the study was to analyze the patterns associated with the risk of developing gallstone disease. Material and methods. The selection of signs of metabolic syndrome among patients of the hospital contingent with cholelithiasis, depending on gender and age, was carried out. There are 271 patients in the general population, of which 227 are women and 49 are men. Statistical processing of research results using the Statistica 8.0 applied software package. Results. Differences in etiology and pathogenesis lead to divergence of the phenotype of patients with cholelithiasis. At the same time, the conservatism of significant risk factors for the development of the disease remains. These include ethnic and sexual dimorphism: Caucasians are twice as likely to suffer from gallstone disease than the Khakass (7.3 and 3.4%, respectively). The incidence of gallstones in women is 8.6% (Caucasians - 10.9%; Khakaski - 6.2%). The indicators for women are 4.6 times higher than for men - 1.9% (Caucasians - 2.5%; Khakass - 1.3%). Older age: after 60 years, the number of patients increases exponentially, gender differences decrease. In the rating of comorbidities, the following are most often recorded: abdominal obesity (92.3% of patients), excess body weight (87.8%); violation of carbohydrate metabolism (86.4%), hypertension (81.7%), atherogenic dyslipidemia (50.6%) and NAFLD (23.6%). Conclusion. Together with conservative factors of susceptibility to gallstones that cannot be modified (age increase, female sex, heredity), a pathological phenotype known as metabolic syndrome is often formed. An increase in the frequency of gallstones is associated with variable combinations of metabolic syndrome components. Early detection of these signs can be used to predict and prevent the disease, since they are all modified to one degree or another. In addition, along with the conventional criteria for metabolic syndrome, the expression of gallstone disease has been established, which makes it possible to consider it a full-fledged sign.