Pediatric Obesity and Gallstone Disease

Abstract

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.

Laparoscopic cholecystectomy in childhood: a review of twenty-four consecutive cases

“…However, it was found out that the patients aged less than six years had received ceftriaxone therapy because of urinary tract infection. Obesity has been reported to be a potential cause of gallbladder stone in children; however, only six of our patients were obese [1,5]. Nevertheless, it has been claimed that the process of gallstone formation is different in children under the age of 10 when particularly compared to adults, because in pediatric patients, the larger part of the gallbladder stone is composed of pigment stones while the smaller part is of cholesterol stones [6].…”

“…Although it has been reported to be usually to hemolytic diseases (10-40% higher as compared to normal population), the leading cause of gallbladder stone is generally idiopathic in published series and reported to be detected incidentally while investigating other abdominal pathologies [3]. On the other hand, it may also be seen in premature babies or children who have encountered severe nutritional problems and parenteral nutrition, serious abdominal surgery, familial predisposition, cystic fibrosis, ceftriaxone therapy, obesity, dehydration, endocrine disorders, genetic liver diseases or it may be dietinduced [4,5]. The patients included in this study had undergone hematologic and gastroenterologic investigations preoperatively; no hemolytic, endocrinologic or metabolic disorder was detected.…”

A snapshot of cancer in Chile: analytical frameworks for developing a cancer policy

“…The authors of this publication conclude, again demonstrating Chile’s rapid incorporation of a westernized lifestyle, that the incidence of obesity-related cancers resembled the distribution of the USA and the UK more than developing countries [39]. Obesity-related health problems maybe confounded in coming years by the observation of increased gallstone incidence in obese and overweight children [50]. This, coupled to the observation that all gallbladder cancer patients first present gallstones, may further increase Chile´s notorious burden of gallbladder cancer.…”

Laparoscopic cholecystectomy in gallbladder stone: Is there any difference in clinical and procedure characteristics between children and adults?

“…Bunun arkasındaki etiyoloji çok unsurludur; çocukluk çağında obezitenin artmasının yanı sıra genetik faktörler ve gelişmiş tanısal yöntemlerin rol oynadığını destekleyen kanıtlar bulunmuştur (3)(4)(5) . Safra kesesi taşları, çocuklarda hematolojik kökenli iken, erişkinlerde daha çok kolesterol veya pigment taşları-dır (3,6) . Çalışmamızda, obezite erişkinlerin yarısından fazlasında saptanırken, yalnızca 3 çocukta VKİ yük-sek bulundu.…”