fact that obesity is a risk factor for gallstones, particularly Data on the association between cholelithiasis and diamong women. 6,7 Therefore, the association of gallstones with abetes often are controversial and are mostly based on an altered carbohydrate metabolism may be hypothesized. autopsies or on hospital series. Therefore, we designed
In addition, other risk factors, such as aging, are common to a case-control study to determine the prevalence of diaboth diseases. betes mellitus in a group of subjects with gallstones or
In light of the above we designed a case-control study to having undergone cholecystectomy (cases) and comdetermine the prevalence of diabetes mellitus in a group of pared these with a control group of subjects without subjects with gallstones or having undergone cholecystecgallstones, selected during an epidemiological study pertomy and in a control group without gallstones. Both groups, formed on a free-living population sample. The subjects which were comparable for sex, age, and body mass index were matched for sex, age, and body mass index. We (BMI), were extracted from a free-living population sample. enlisted 336 cases and 336 controls, aged 30 to 69 years. All subjects with fasting glycemic levels of Γ΅140 mg/dL PATIENTS AND METHODS and without a documented history of diabetes were submitted to a simplified oral glucose tolerance test (OGTT).
This study was performed in a cohort from Tivoli, Rome, who All subjects who underwent OGTT were classified acparticipated in a multicenter epidemiological study to assess the prevalence of gallstones among the Italian population (Multicentrica cording to the National Diabetes Data Group (NDDG) Italiana Colelitiasi M.I.Col). 15 The population sample, aged 30 to 69 criteria. The prevalence of diabetes in the subjects afyears, was obtained by choosing at random voters from the electoral fected by gallstone disease was significantly higher than registers. The screening began in July 1985 and finished in July that in controls (11.6% vs. 4.8%; odds ratio [OR], 2.55; 95%
- The individuals enlisted received a mail invitation to particiconfidence interval [CI], 1.39-4.67). Diabetes was more pate in a general program of preventive medicine. The participation frequent in subjects with gallstone disease than in the rate was 62.5% for men and 62.8% for women and was uniform for control group, even according to sex (18.3% vs. 9.9% for all age classes. Furthermore, the age and sex of nonparticipants were men: OR, 2.03; 95% CI, 0.99-4.2; 9.3% vs. 2.6% for women: similar to those of participants. 15 Informed consent was obtained OR, 3.85; 95% CI, 1.4-10.6). We conclude that an altered from each participant.
Each participant underwent a physical examination, blood analy-glucose metabolism may increase the risk of developing sis, and ultrasonography of the gallbladder and biliary tree using cholelithiasis in certain subjects. (HEPATOLOGY 1997; real-time equipment with a 3.5-MHz linear transducer (Mod Sigma 25:787-790.) 20; Kontron, Montigny Le Bretonneux, France). The participants were examined in the supine and left decubitus position. The exami-10.2 years and 28.19 { 3.7 kg/m 2 in the control group. The difference was not statistically significant. Both cases and controls were classified as diabetic subjects, sub-Abbreviations: BMI, body mass index; GD, gallstone disease; IGT, impaired glucose jects with impaired glucose tolerance (IGT), normal subjects, or undetolerance; OGTT, oral glucose tolerance test; NDDG, National Diabetes Data Group; OR, termined.
odds ratio; 95% CI, 95% confidence interval.
The following subjects were considered diabetic: (1) subjects with