title: Helicobacter pylori infection is positively associated with gallstones: a large-scale cross-sectional study in Japan.
abstract: BACKGROUND
  Our aim is to elucidate causative factors for gallstones, especially focusing on Helicobacter pylori (HP) infection.
  
  
  METHODS
  We analyzed 15,551 Japanese adults who had no history of gastrectomy, cholecystectomy, HP eradication, and didn't use proton pump inhibitors, anti-diabetic drugs, or anti-cholesterol drugs. 1,057 subjects who previously had HP eradication were analyzed separately.
  
  
  RESULTS
  Gallstones were detected in 409 of 8,625 men (4.74%) and 285 of 6,926 women (4.11%) by ultrasonography. Among the 25 factors univariately analyzed, age, HP infection, alcohol intake, weight, body mass index (BMI), and 14 blood test values (AST, ALT, ALP, γ-GTP, T-Chol, HDL-Chol, LDL-Chol, TG, TP, Hb, HbA1c, pepsinogen I, pepsinogen II, and pepsinogen I/II ratio) displayed significant association with gallstones (p < 0.05), whereas gender, smoking, height, and three blood test values (Alb, T-Bil, MCV) did not. Multivariate analysis showed that age, gender, alcohol intake, BMI, γ-GTP, LDL-Chol, TP, and HP infection had significant association (p < 0.05). Successive multiple logistic regression analysis calculating odds ratio (OR) and standardized coefficients (β) showed that age (OR/β = 1.57/0.450), BMI (OR/β = 1.30/0.264), HP infection (OR/β = 1.51/0.206), lower alcohol intake (OR/β = 1.33/0.144), γ-GTP (OR/β = 1.15/0.139), and pepsinogen I/II ratio (OR/β = 1.08/0.038) have significant positive association with gallstones, whereas gender does not. The gallstone prevalence among HP-negative, HP-eradicated, and HP-positive subjects was 3.81, 4.73 and 6.08%, respectively. The matched analysis controlling age, BMI, γ-GTP, alcohol intake, pepsinogen I/II ratio and gender also demonstrated that gallstone prevalence among HP-eradicated subjects was significantly lower compared with HP-positive subjects (p < 0.05).
  
  
  CONCLUSIONS
  HP infection is positively associated with gallstones. HP eradication may lead to prevention of gallstones.
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan, yutakahashi-tky@umin.ac.jp.
authors.forename: Yu
authors.initials: Y
authors.lastname: Takahashi
authors.forename: Nobutake
authors.initials: N
authors.lastname: Yamamichi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Shimamoto
authors.forename: Satoshi
authors.initials: S
authors.lastname: Mochizuki
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Fujishiro
authors.forename: Chihiro
authors.initials: C
authors.lastname: Takeuchi
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Sakaguchi
authors.forename: Keiko
authors.initials: K
authors.lastname: Niimi
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ono
authors.forename: Shinya
authors.initials: S
authors.lastname: Kodashima
authors.forename: Toru
authors.initials: T
authors.lastname: Mitsushima
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Koike
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D042882:Gallstones / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology*; D016481:Helicobacter Infections / Q000150:complications*; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D055815:Young Adult