Pediatric obesity and gallstone disease.
OBJECTIVE
The aim of the present study was 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 the electronic medical records of 510,816 patients ages 10 to 19 years enrolled in an integrated health plan, 2007-2009.


RESULTS
We identified 766 patients with gallstones. The adjusted odds ratios (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 were 1.00, 2.73 (2.18%-3.42%), 5.75 (4.62%-7.17%), and 7.71 (6.13%-9.71%), respectively (P for interaction sex × weight class <0.001). Among girls, oral contraceptive use was associated with higher odds for gallstones (odds ratio 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 toward extreme childhood obesity, especially in minority children, pediatricians can expect to face increasing numbers of children and adolescents affected by gallstone disease.
Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA. Corinna.Koebnick@kp.org
Corinna
C
Koebnick
Ning
N
Smith
Mary Helen
MH
Black
Amy H
AH
Porter
Bradley A
BA
Richie
Sharon
S
Hudson
Deborah
D
Gililland
Steven J
SJ
Jacobsen
George F
GF
Longstreth
D000293:Adolescent; D000328:Adult; D001835:Body Weight; D002648:Child; D003267:Contraception / Q000706:statistics & numerical data*; D003276:Contraceptives, Oral; D003430:Cross-Sectional Studies; D005260:Female; D042882:Gallstones / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D008297:Male; D009765:Obesity / Q000150:complications*; D009767:Obesity, Morbid / Q000150:complications; D016017:Odds Ratio; D015995:Prevalence; D012016:Reference Values; D012737:Sex Factors; D013851:Thinness / Q000150:complications; D055815:Young Adult
D003276:Contraceptives, Oral