The prevalence of gallstones in chronic liver disease is related to degree of liver dysfunction.
OBJECTIVE
Earlier studies have indicated an elevated risk for gallstone disease in patients with cirrhosis. This study aimed to evaluate the prevalence of gallstones in patients with chronic liver disease (CLD) with respect to sex, etiology, and severity of liver disease.


METHODS
Four hundred and thirteen adults (176 women), mean age 51.2+/-14 years, with CLD, who had undergone liver biopsy during 1978-1993, and from whom sera were available, were investigated retrospectively. The results were compared with a population-based ultrasonography study of 556 healthy men and women, in their 40s and 60s.


RESULTS
The prevalence of gallstones in patients with CLD did not differ from that in the control population. An increased frequency was observed in patients with CLD initially classified as cryptogenic, of whom the majority (60%) later were reclassified as chronic hepatitis C. The frequency of gallstones was also high in PiZ-heterozygotes for alpha1-antitrypsin deficiency (5/21, 24%) compared to non-PiZ-carriers (17/389, 4.8%), (p<0.001). In 67 patients with histologic evidence of cirrhosis, 30% (20/67) had gallstones (vs. 15% in the general population, p<0.01). The prevalence of gallstones increased significantly from Child's class A (16%) to C (56.2%). The difference was significant in males (18.2% vs. 62.5%, p=0.033), but not in females. Fifty percent of the patients with gallstones were symptomatic.


CONCLUSIONS
Progressive liver dysfunction is a risk factor for gallstones particularly in males. HCV infection and PiZ carriership may further increase biliary lithogenesis.
Elzouki
A N
AN
Department of Medicine, University Hospital, Malmö, Sweden.
Nilsson
S
S
Nilsson
P
P
Verbaan
H
H
Simanaitis
M
M
Lindgren
S
S
D000328:Adult; D000368:Aged; D002769:Cholelithiasis / Q000175:diagnosis* / Q000235:genetics; D002908:Chronic Disease; D005260:Female; D006580:Genetic Carrier Screening; D006801:Humans; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000235:genetics; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D000515:alpha 1-Antitrypsin / Q000235:genetics
D000515:alpha 1-Antitrypsin