Increasing gallstone disease prevalence and associations with gallbladder and biliary tract mortality in the US

Abstract

Background and Aims: We examined gallbladder and biliary tract mortality predictors in the US National Health and Nutrition Examination Survey (NHANES), 1988-1994, with 31 years of linked mortality data, and gallstone disease prevalence trends and associations in NHANES 2017-March 2020 prepandemic data. Approach and Results: In NHANES 1988-1994, 18,794 participants were passively followed for mortality, identified by death certificate underlying or contributing causes, by linkage to the National Death Index through 2019. In NHANES 2017-March 2020, gallstone disease history was ascertained from 9232 adults. During NHANES 1988-2019 follow-up (median, 23.3 y), 8580 deaths occurred from all causes and 72 deaths with gallbladder or biliary tract disease. In multivariable-adjusted analysis, older age, male sex, prediabetes or diabetes, and physical inactivity were associated with gallbladder and biliary tract mortality, and non-Hispanic Black and Mexican American race-ethnicity were inversely associated. Between 1988-1994 and 2017-March 2020, gallstone disease prevalence increased from 7.4% to 13.9% and gallbladder surgery from 6.0% to 11.6%. In 2017-March 2020 in multivariable-adjusted analysis, female sex, diabetes, liver disease, proton pump inhibitors, abdominal pain, increased age, BMI, and liver stiffness were associated with gallstone disease, and non-Hispanic Black and non-Hispanic Asian race and alcohol were inversely associated. Conclusions: In the US population, gallstone disease prevalence doubled over 3 decades, possibly because of the worsening of metabolic risk factors and growth of laparoscopic cholecystectomy. Gallbladder and biliary tract mortality and gallstone disease associations included factors such as prediabetes or diabetes, liver stiffness and proton pump inhibitors.

Early prediction of gallstone disease with a machine learning-based method from bioimpedance and laboratory data

“…[61] In another study, gallstone formation was higher in patients with type-2 diabetes, but this could not be statistically proven. [62] Everson et al found that individuals with hemoglobin metabolism disorders, such as sickle hemoglobinopathy, have an enlarged gallbladder that contributes to the formation of gallstones. [63] A study by Fu et al [64] also suggested that the ratio of beta-lipoprotein and LDL cholesterol to HDL cholesterol is a risk factor for gallbladder stone formation.…”

Bouveret Syndrome: A Rare and Often Fatal Form of Gallstone Ileus

“…Our patient is unique in the fact that he did not fit any of the usual criteria for BS. Upon further literature search, it was seen that Hispanic, specifically Hispanic Americans, are at higher risk of gallstone formation than other races in the United States [6][7][8][9]. Certain genetic factors could explain the formation of gallstones in a Hispanic individual with no apparent risk factors [8].…”

The four seasons of pancreatitis – Etiology of acute pancreatitis during the course of the year

“…Acute pancreatitis (AP) is one of the most common non-malignant reasons for hospital admission to gastroenterology, which, with an increasing incidence worldwide, leads to a high burden for healthcare systems [1,2]. The relevance of biliary pancreatitis etiologies in particular, with an annual increase in incidence of 3.6 %, is due to improved endosonographic diagnostics and, at the same time, a global increase in non-communicable metabolic diseases, which favor gallstone formation [1,3,4]. Seasonal and circadian dysregulation and their influence on the development and progression of disease is an under-investigated research area, not only with regard to the pancreas [5].…”