title: Gallstone disease and the risk of stroke: a nationwide population-based study.
abstract: BACKGROUND
  Gallstone disease (GD) and stroke share a number of risk factors including diabetes and hyperlipidemia. This nationwide population-based study was designed to estimate the risk of stroke after a diagnosis of GD.
  
  
  METHODS
  Data were obtained from the Taiwan National Health Insurance Research Database. A total of 135,512 patients with a diagnosis of GD and 271,024 age- and gender-matched non-GD control patients were included to assess the risk of stroke using Cox proportional hazard regression.
  
  
  RESULTS
  During the study period (2000-2003), 12,234 (153.67/10,000 person-years) strokes occurred among the GD patients, and 20,680 (114.83/10,000 person-years) among the controls. The diagnosis of GD carried a higher risk of developing ischemic and hemorrhagic stroke, with a hazard ratio (HR) of 1.28 and 1.33 (95% confidence interval [CI], 1.25-1.31 and 1.25-1.41, both P < .0001), respectively. Stroke risk was increased in both genders but at a higher rate in younger age. The GD group had significantly higher prevalence rate of comorbidities that are known stroke risk factors, including hypertension, diabetes, and coronary artery disease. Stroke risk was higher in the GD group with or without any of these comorbidities.
  
  
  CONCLUSIONS
  In this population-based longitudinal follow-up study, GD carried a significantly higher stroke risk, particularly for younger age with or without stroke risk factors. Stroke preventive measures maybe needed for patients with GD, especially those of younger age and with stroke risk factor(s).
authors: Department of Neurology, Chang Bing Show Chwan Memorial Hospital, Changhua County, Taiwan, Republic of China; Department of Exercise and Health Promotion, College of Education, Chinese Culture University, Taipei, Taiwan, Republic of China.
authors: Cheng-Yu
authors: CY
authors: Wei
authors: Graduate Institute of Health Care, Meiho University, Pingtung County, Taiwan, Republic of China.
authors: Tieh-Chi
authors: TC
authors: Chung
authors: Digestive Disease Center, Chang Bing Show Chwan Memorial Hospital, Changhua County, Taiwan, Republic of China.
authors: Chien-Hua
authors: CH
authors: Chen
authors: Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan, Republic of China.
authors: Che-Chen
authors: CC
authors: Lin
authors: Department of Public Health, China Medical University, Taichung, Taiwan, Republic of China.
authors: Fung-Chang
authors: FC
authors: Sung
authors: Graduate Institute of Clinical Medicine, Taipei Medical University, Taipei, Taiwan, Republic of China.
authors: Wen Ting
authors: WT
authors: Chung
authors: Department of Exercise and Health Promotion, College of Education, Chinese Culture University, Taipei, Taiwan, Republic of China; Department of Neurosurgery, Lo-Hsu Foundation, Lotung Poh-Ai Hospital, Yilan, Taiwan, Republic of China.
authors: Woon-Man
authors: WM
authors: Kung
authors: Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan, Republic of China.
authors: Chung Y
authors: CY
authors: Hsu
authors: Digestive Disease Center, Chang Bing Show Chwan Memorial Hospital, Changhua County, Taiwan, Republic of China. Electronic address: yehyeh41@gmail.com.
authors: Yung-Hsiang
authors: YH
authors: Yeh
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D042882:Gallstones / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011153:Population; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D020521:Stroke / Q000150:complications* / Q000453:epidemiology; D013624:Taiwan / Q000453:epidemiology
keywords: Stroke; cholelithiasis; epidemiology; gallstone disease; risk factors