Gallstones, gallbladder disease, and pancreatitis: cross-sectional and 2-year data from the Swedish Obese Subjects (SOS) and SOS reference studies.
OBJECTIVE
Obesity and weight loss have been associated with gallstone disease. There is also an association between gallstones and pancreatitis. We investigated cross-sectional relationships between body mass index (BMI), body fat distribution, and prevalence of gallstones, gallbladder disease, and pancreatitis in men and women. Furthermore, 2-yr incidences of these disorders were examined in relation to changes in weight and body fat distribution after surgical and conventional obesity treatment.


METHODS
Self-administered questionnaires were used to assess biliary and pancreatic disease. In the cross-sectional investigation, 6328 obese patients and 1135 randomly selected reference individuals were used. Longitudinally, 1422 operated and 1260 conventionally treated patients were examined.


RESULTS
Obese subjects had significantly higher prevalence of cholelithiasis, cholecystitis, cholecystectomies, and pancreatitis as compared with the reference population. In women, BMI and waist-hip ratio (WHR) were independently related to an increased biliary disease prevalence. In men, only BMI was independently associated with biliary disease. Compared with conventional treatment, obesity surgery significantly increased the incidence of cholelithiasis, cholecystitis, and cholecystectomies in men. There was no incidence difference among women. In both genders, weight loss, but not change in WHR, was related to an increased incidence of biliary disease.


CONCLUSIONS
This study showed an increased prevalence of gallstones, gallbladder disease, and pancreatitis in the obese. Biliary disease was related to BMI and WHR in women, but only to BMI in men. Weight loss, but not change in WHR, increased the risk of biliary disease in both genders.
Torgerson
Jarl S
JS
Swedish Obese Subjects Secretariat, Department of Body Composition and Metabolism, Sahlgrenska University Hospital, Göteborg, Sweden.
Lindroos
Anna Karin
AK
Näslund
Ingmar
I
Peltonen
Markku
M
D000328:Adult; D001824:Body Constitution; D015992:Body Mass Index; D002763:Cholecystectomy / Q000706:statistics & numerical data; D002764:Cholecystitis / Q000150:complications* / Q000453:epidemiology / Q000601:surgery; D002769:Cholelithiasis / Q000150:complications* / Q000453:epidemiology / Q000601:surgery; D003430:Cross-Sectional Studies; D005260:Female; D005704:Gallbladder / Q000473:pathology / Q000601:surgery; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000453:epidemiology; D016017:Odds Ratio; D010195:Pancreatitis / Q000150:complications* / Q000453:epidemiology; D015995:Prevalence; D012016:Reference Values; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology; D015431:Weight Loss