title: Incidence of gallstone disease in Italy: results from a multicenter, population-based Italian study (the MICOL project).
abstract: OBJECTIVE
  To evaluate gallstone incidence and risk factors in a large population-based study.
  
  
  METHODS
  Gallstone incidence and risk factors, were evaluated by structured questionnaire and physical examination, respectively, in 9611 of 11 109 (86.5%) subjects who were gallstone-free at the cross-sectional study.
  
  
  RESULTS
  Six centers throughout Italy enrolled 9611 subjects (5477 males, 4134 females, aged 30-79 years), 9517 of whom were included into analysis: 424 subjects (4.4%) had gallstones and 61 (0.6%) had been cholecystectomized yielding a cumulative incidence of 0.67% per year (0.66% in males, 0.81% in females). Increasing age, a high body mass index (BMI), a history of diabetes, peptic ulcer and angina, and low cholesterol and high triglyceride levels were identified as risk factors in men while, in females, the only risk factors were increasing age and a high BMI. Increasing age and pain in the right hypocondrium in men and increasing age in females were identified as predictors of gallstones. Pain in the epigastrium/right hypocondrium was the only symptom related to gallstones; furthermore, some characteristics of pain (forcing to rest, not relieved by bowel movements) were significantly associated with gallstones. No correlation was found between gallstone characteristics and clinical manifestations, while increasing age in men and increasing age and BMI in females were predictors of pain.
  
  
  CONCLUSIONS
  Increasing age and BMI represent true risk factors for gallstone disease (GD); pain in the right hypocondrium and/or epigastrium is confirmed as the only symptom related to gallstones.
authors.affiliation: Dipartimento di Medicina Interna e Gastroenterologia, Policlinico S. Orsola-Malpighi, Via Massarenti 9, Bologna 40138, Italy. davide.festi@unibo.it
authors.forename: Davide
authors.initials: D
authors.lastname: Festi
authors.forename: Ada
authors.initials: A
authors.lastname: Dormi
authors.forename: Simona
authors.initials: S
authors.lastname: Capodicasa
authors.forename: Tommaso
authors.initials: T
authors.lastname: Staniscia
authors.forename: Adolfo-F
authors.initials: AF
authors.lastname: Attili
authors.forename: Paola
authors.initials: P
authors.lastname: Loria
authors.forename: Paolo
authors.initials: P
authors.lastname: Pazzi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Mazzella
authors.forename: Claudia
authors.initials: C
authors.lastname: Sama
authors.forename: Enrico
authors.initials: E
authors.lastname: Roda
authors.forename: Antonio
authors.initials: A
authors.lastname: Colecchia
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005260:Female; D042882:Gallstones / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000503:physiopathology; D012307:Risk Factors
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