Incidence of gallstone disease in Italy: results from a multicenter, population-based Italian study (the MICOL project).
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.
Festi
Davide
D
Dipartimento di Medicina Interna e Gastroenterologia, Policlinico S. Orsola-Malpighi, Via Massarenti 9, Bologna 40138, Italy. davide.festi@unibo.it
Dormi
Ada
A
Capodicasa
Simona
S
Staniscia
Tommaso
T
Attili
Adolfo-F
AF
Loria
Paola
P
Pazzi
Paolo
P
Mazzella
Giuseppe
G
Sama
Claudia
C
Roda
Enrico
E
Colecchia
Antonio
A
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
Hepatology. 1997 Oct;26(4):809-18
9328297
Hepatology. 1999 Oct;30(4):839-46
10498631
Curr Gastroenterol Rep. 2005 May;7(2):132-40
15802102
Am J Clin Nutr. 2004 Jul;80(1):1-2
15213019
Ital J Gastroenterol Hepatol. 1997 Jun;29(3):249-54
9646217
J Laparoendosc Surg. 1993 Feb;3(1):77-90
8453137
World J Gastroenterol. 2005 Mar 21;11(11):1653-7
15786544
Hepatogastroenterology. 1994 Jun;41(3):263-6
7959550
Gastroenterol Clin North Am. 1991 Mar;20(1):1-19
2022415
Gastroenterology. 2002 May;122(5):1500-11
11984534
Gastroenterology. 2004 May;126(5):1448-53
15131804
Gut. 1991 Mar;32(3):316-20
2013429
Aliment Pharmacol Ther. 2003 Nov;18 Suppl 3:49-53
14531741
Gut. 1989 Feb;30(2):201-5
2649414
Am J Epidemiol. 1995 Jan 15;141(2):158-65
7817971
Postgrad Med J. 2000 Nov;76(901):700-3
11060144
Ann Intern Med. 1993 Oct 1;119(7 Pt 1):620-2
8204129
Am J Clin Nutr. 2004 Jul;80(1):38-44
15213025
JAMA. 1993 Sep 22-29;270(12):1429-32
8371441
Gastroenterology. 1998 Oct;115(4):937-46
9753497
Hepatology. 1987 Sep-Oct;7(5):913-7
3653855
Am J Epidemiol. 1987 Nov;126(5):912-21
3310613
Dig Dis Sci. 1987 Apr;32(4):349-53
3549203
Eur J Gastroenterol Hepatol. 1996 Jun;8(6):585-93
8823575
Eur J Epidemiol. 1994 Apr;10(2):143-50
7813691
Scand J Gastroenterol. 1987 Nov;22(9):1089-94
3321395
Am J Gastroenterol. 2005 Apr;100(4):827-30
15784027
Dig Dis Sci. 1994 Aug;39(8):1697-703
8050320
Am J Epidemiol. 1988 Sep;128(3):598-605
3046339
Gastroenterology. 1991 Mar;100(3):790-4
1993501
J Clin Ultrasound. 1999 Jan;27(1):1-7
9888092
Gastroenterology. 1999 Sep;117(3):632-9
10464139
Hepatology. 2002 Jun;35(6):1507-12
12029637