Gallstone Prevalence and Risk Factors for Gallstone Disease in an Urban Population of Children and Adolescents

Kratzer, Wolfgang; Walcher, Thomas; Arnold, Forest W.; Akinli, A. S.; Mason, Richard; Denzer, Christian; Böhm, Birgit; Imhof, Armin; Hänle, M

doi:10.1055/s-0028-1109957

Cited by 17 publications

(12 citation statements)

References 9 publications

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“…Cholesterol stones, in fact, are becoming increasingly more common in children 169-171. In unselected pediatric populations, the prevalence rates are reported between 0.1% to 1.0% 170,172. One explanation for this increase is greater access to and use of abdominal ultrasonography in children 173.…”

Section: Gallstone Diseasementioning

confidence: 99%

“…In obese children and adolescents, the prevalence may be as high as 2.0% 171. Other risk factors for gallstone disease in childhood include: female gender, pregnancy and oral contraceptive use; being of Mexican-American origin; drug exposure to cephalosporins, ceftriaxone or diuretics; a history of cardiac surgery or bowel resection, and having cystic fibrosis 149,172,173,176. In fact, the risk factors for pediatric gallbladder disease now more closely resemble those in adults.…”

Section: Gallstone Diseasementioning

confidence: 99%

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Epidemiology of Gallbladder Disease: Cholelithiasis and Cancer

Stinton¹,

Shaffer²

2012

Gut Liver

1,011

783

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Diseases of the gallbladder are common and costly. The best epidemiological screening method to accurately determine point prevalence of gallstone disease is ultrasonography. Many risk factors for cholesterol gallstone formation are not modifiable such as ethnic background, increasing age, female gender and family history or genetics. Conversely, the modifiable risks for cholesterol gallstones are obesity, rapid weight loss and a sedentary lifestyle. The rising epidemic of obesity and the metabolic syndrome predicts an escalation of cholesterol gallstone frequency. Risk factors for biliary sludge include pregnancy, drugs like ceftiaxone, octreotide and thiazide diuretics, and total parenteral nutrition or fasting. Diseases like cirrhosis, chronic hemolysis and ileal Crohn's disease are risk factors for black pigment stones. Gallstone disease in childhood, once considered rare, has become increasingly recognized with similar risk factors as those in adults, particularly obesity. Gallbladder cancer is uncommon in developed countries. In the U.S., it accounts for only ~ 5,000 cases per year. Elsewhere, high incidence rates occur in North and South American Indians. Other than ethnicity and female gender, additional risk factors for gallbladder cancer include cholelithiasis, advancing age, chronic inflammatory conditions affecting the gallbladder, congenital biliary abnormalities, and diagnostic confusion over gallbladder polyps.

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Section: Gallstone Diseasementioning

confidence: 99%

Section: Gallstone Diseasementioning

confidence: 99%

Epidemiology of Gallbladder Disease: Cholelithiasis and Cancer

Stinton¹,

Shaffer²

2012

Gut Liver

1,011

783

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show abstract

“…Concomitant with the epidemic of childhood obesity [7, 8] and the shift towards extreme childhood obesity [7], the prevalence of gallstones in children and adolescents may be increasing due to childhood obesity. Results from small hospital-based studies suggest that obesity may be a risk factor for gallstones in adolescents [9, 10]. Cholecystectomy is also becoming more frequent in this age group [11].…”

Section: Introductionmentioning

confidence: 99%

Pediatric Obesity and Gallstone Disease

Koebnick

Smith

Black

et al. 2012

J. pediatr. gastroenterol. nutr.

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Objectives To investigate the association between childhood and adolescent obesity, the risk of gallstones and the potential effect modification by oral contraceptive use in girls. Methods For this population-based cross-sectional study, measured weight and height, oral contraceptive use, and diagnosis of cholelithiasis or choledocholithiasis were extracted from electronic medical records of 510,816 patients aged 10–19 years enrolled in an integrated health plan 2007–2009. Results We identified 766 patients with gallstones. The adjusted ORs (95% CI) of gallstones for under/normal weight (=reference), overweight, moderate obesity, and extreme obesity in boys were 1.00, 1.46 (0.94–2.27), 1.83 (1.17–2.85), and 3.10 (1.99–4.83) and in girls 1.00, 2.73 (95% CI 2.18–3.42), 5.75 (4.62–7.17), and 7.71 (6.13–9.71), respectively (P for interaction sex × weightclass <0.001). Among girls, oral contraceptive use was associated with higher odds for gallstones (OR 2.00, 95% CI 1.66–2.40). Girls who used oral contraceptives were at higher odds for gallstones than their counterparts in the same weight class who did not use oral contraceptives (P for interaction weight class × oral contraceptive use = 0.023). Conclusions Due to the shift towards extreme childhood obesity, especially in minority children, pediatricians can expect to face increasing numbers of children and adolescents affected by gallstone disease.

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“…In a Canadian population-based, retrospective cohort, the crude incidence of cholecystectomy in subjects under 18 years of age increased from 8.8 per 100,000 person-years in 1993 to 13.0 per 100,000 person-years in 2012 8 , and a retrospective study in the US over a nine-year period ending in 2012 registered an increment of cholecystectomies due to pediatric non-hemolytic (cholesterol) gallstones of 216% 9 . It has been suggested that this epidemiologic increment during childhood could be due to the increasing prevalence of obesity 6 , 10 – 16 , physical inactivity, diabetes, and early pregnancy 6 .…”

Section: Introductionmentioning

confidence: 99%

Recent advances in understanding and managing cholesterol gallstones

Ciaula

Portincasa

2018

F1000Res

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The high prevalence of cholesterol gallstones, the availability of new information about pathogenesis, and the relevant health costs due to the management of cholelithiasis in both children and adults contribute to a growing interest in this disease. From an epidemiologic point of view, the risk of gallstones has been associated with higher risk of incident ischemic heart disease, total mortality, and disease-specific mortality (including cancer) independently from the presence of traditional risk factors such as body weight, lifestyle, diabetes, and dyslipidemia. This evidence points to the existence of complex pathogenic pathways linking the occurrence of gallstones to altered systemic homeostasis involving multiple organs and dynamics. In fact, the formation of gallstones is secondary to local factors strictly dependent on the gallbladder (that is, impaired smooth muscle function, wall inflammation, and intraluminal mucin accumulation) and bile (that is, supersaturation in cholesterol and precipitation of solid crystals) but also to “extra-gallbladder” features such as gene polymorphism, epigenetic factors, expression and activity of nuclear receptors, hormonal factors (in particular, insulin resistance), multi-level alterations in cholesterol metabolism, altered intestinal motility, and variations in gut microbiota. Of note, the majority of these factors are potentially manageable. Thus, cholelithiasis appears as the expression of systemic unbalances that, besides the classic therapeutic approaches to patients with clinical evidence of symptomatic disease or complications (surgery and, in a small subgroup of subjects, oral litholysis with bile acids), could be managed with tools oriented to primary prevention (changes in diet and lifestyle and pharmacologic prevention in subgroups at high risk), and there could be relevant implications in reducing both prevalence and health costs.

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Gallstone Prevalence and Risk Factors for Gallstone Disease in an Urban Population of Children and Adolescents

Abstract: Obesity appears to be a risk factor in the development of gallstones in childhood and adolescence.

Cited by 17 publications

References 9 publications

Epidemiology of Gallbladder Disease: Cholelithiasis and Cancer

Epidemiology of Gallbladder Disease: Cholelithiasis and Cancer

Pediatric Obesity and Gallstone Disease

Recent advances in understanding and managing cholesterol gallstones

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