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Query: UMLS:C0028754 (obesity)
 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Gallstone formation is a heterogeneous disease for which supersaturation of bile with cholesterol and hemolysis of RBCs are major driving forces associated with initial formation and growth. Specific risk factors are superimposed on the gradually increasing prevalence of gallstones with age in most populations. Major risk factors associated with cholesterol gallstone formation are American Indian ancestry, female sex, obesity, and ingestion of lithogenic drugs, such as estrogen-containing preparations and clofibrate. Hemolysis and cirrhosis are risk factors for pigment stones.
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PMID:Who gets gallstones and why. 47 49

The most certain symptomatic manifestation of gallstones is episodic upper abdominal pain. Characteristically, this pain is severe and located in the epigastrium and/or the right upper quadrant. The onset is relatively abrupt and often awakens the patient from sleep. The pain is steady in intensity, may radiate to the upper back, be associated with nausea and lasts for hours to up to a day. Dyspeptic symptoms of indigestion, belching, bloating, abdominal discomfort, heartburn and specific food intolerance are common in persons with gallstones, but are probably unrelated to the stones themselves and frequently persist after surgery. Many, if not most, persons with gallstones have no history of pain attacks. Persons discovered to have gallstones in the absence of typical symptoms appear to have an annual incidence of biliary pain of 2-5% during the initial years of follow-up, with perhaps a declining rate thereafter. Gallstone-related complications occur at a rate of less than 1% annually. Those whose stones are symptomatic at discovery have a more severe course, with approximately 6-10% suffering recurrent symptoms each year and 2% biliary complications. The far higher rates of symptom development reported in a few studies raise the possibility that these incidence estimates may be too low. The best predictors of future biliary pain are a history of pain at the time of diagnosis, female gender and possibly obesity. The risk of acute cholecystitis appears to be greater in those with large solitary stones, that of biliary pancreatitis in those with multiple small stones, and that of gallbladder cancer in those with large stones of any number. Drugs that inhibit the synthesis of prostaglandins may now be the treatment of choice in patients with gallstones who are suffering acute pain attacks. Persistent dyspeptic symptoms occur frequently following cholecystectomy. A prolonged history of such symptoms prior to surgery and evidence of significant psychological distress appear to be the best predictors of unsatisfactory outcome.
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PMID:Symptoms of gallstone disease. 148 6

The relation between symptomatic cholelithiasis in women under 30 years of age and pregnancy, obesity and oral contraceptive use was retrospectively studied. A total of 885 cholecystectomies were carried out in an English district hospital. In the age group under 30 years the female-male ratio was 9.7:1 vs 2.3:I in the total group (p less than 0.01). Gallstones were present in 39 women with a previous pregnancy and in 14 women without pregnancy. Compared to an age and sex matched control group of appendicectomies a relative risk of 1.6 was found for pregnancy related gallstone disease requiring cholecystectomy (p less than 0.05). 455 Cholecystectomies were carried out in a Dutch academic hospital. The female-male ratio in the group younger than 30 years was 7.0:I vs 2.3:I in the total group (p less than 0.01). In the Dutch group more women under 30 years were operated on than in the English group: 23% vs 10% (p less than 0.001). There was no significant association between symptomatic gallstones and previous pregnancies in the Dutch group (p = 0.07). Gallstone disease occurs earlier in women than in men. There appears to be a relationship between early symptomatic cholelithiasis and pregnancy in the English group only. No relationship could be found between cholelithiasis and obesity or oral contraceptive use in either group.
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PMID:Gallstone disease in women younger than 30 years. 192 81

Gallstones are common, affecting about one fourth of women and 10% to 15% of men over the age of 50. They are more prevalent in Amerindians and Mexican-Americans and less common in blacks. Principal risk factors are age, sex, and obesity. Lesser risk factors include childbearing, abstinence from alcohol, and some medications. The rate at which asymptomatic gallstones become symptomatic is low but significant, while patients with mildly symptomatic stones are at even greater risk for future pain and complications.
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PMID:Epidemiology and natural history of gallstone disease. 202 15

In order to better evaluate some epidemiological findings observed during previous studies on large samples of free living populations we carried out a case-control study on a randomly selected group of subjects in a health spa, Boario Terme. Seven-hundred and thirty subjects, aged 40-69 years, participated in the study. The study protocol included an ultrasonographic examination of the upper abdomen, a physical examination, a questionnaire, and a blood sample. Prevalence of gallstone disease was two times higher in females (37.2%) than in males (19.7%) (RRMH = 1.88). Fifty out of the 80 gallstone subjects were not aware of the disease prior the study (62.5%), and 60 did not experience any specific biliary symptom (colic) in the 5 years prior the study. The so-called "nonspecific symptoms" were not found related to gallstone disease. Gallstone disease was positively related to number of pregnancies, obesity, and economical status. In conclusion the present study confirmed some results observed during previous epidemiological studies. In regards to symptoms present data suggest that biliary colic is the only specific symptom for gallstone disease. In addition, the high number of asymptomatic gallstones observed in this study suggests the need of more investigations on high-risk populations in order to make earlier diagnosis and eventually to prevent the disease.
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PMID:[The Boario project. A study of the prevalence of lithiasis in a spa population]. 218 69

Findings from studies showing an increased incidence of gallstones in diabetic patients do not control for other variables, such as obesity. There is no proof that diabetic patients have more gallstones. Gallstones do not cause diabetes mellitus. The principal gallbladder pathologic feature in diabetic patients is a functional deficit of uncertain etiologic factors, creating a large, flaccid, poorly emptying organ. Bile acid and lipid composition are usually increased in diabetic patients. Cholecystitis seems to be a more serious disease in diabetic patients, with worse infectious sequelae and more rapid disease progression. This conclusion has not been examined statistically. Even with modern care, the complication rate for operations upon the biliary tract in patients with diabetes is increased. Those with diabetes are generally older than other patients requiring cholecystectomy. Systemic changes of aging partly explain increased morbidity and mortality. Diabetic patients with symptomatic gallbladder disease usually require operation. Risk of cholecystectomy in diabetic patients is similar to that in nondiabetics. Prophylactic cholecystectomy for diabetic patients with "silent" gallstones was formerly recommended because of an apparent high risk of cholecystitis. Until the natural history of gallstones in those with diabetes has been defined, such patients should be considered in danger of serious illness. The risk of acute cholecystitis in diabetic patients with stones is probably significant enough to warrant the performance of early cholecystectomy.
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PMID:Gallstones, cholecystitis and diabetes. 224 90

In a group of 166 type II diabetics hospitalized in a medical department the authors made clinical and ultrasonographic examinations focused on the presence of cholecystolithiasis. The control group was formed by 67 subjects with normal glucose tolerance. None of the patients were hospitalized on account of biliary disease. The purpose of the work was to 1. evaluate the difference in the incidence of cholecystolithiasis in diabetic patients and controls with regard to age and sex, 2. to assess differences in the incidence of obesity, impaired lipid metabolism and a positive biliary family--history in diabetics and controls with lithiasis, 3. to evaluate diabetes and the presence of microalbuminuria. In the authors' group cholecystolithiasis is significantly more frequent in diabetics as compared with controls, in men, women and people above 65 years (p less than 0.01). The group of diabetics and controls with lithiasis does not differ as to the incidence of obesity, hyperlipoproteinaemia and positive family-history of biliary disease. No significant differences in parameters of compensation of diabetes nor differences in the incidence of microalbuminuria were found between diabetics with and without lithiasis. The results suggest that it is useful to screen cholecystolithiasis in diabetic subjects.
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PMID:[Cholecystolithiasis in type II diabetics]. 225 72

The role of serum lipids in the etiology of cholesterol gallstones and pigment gallstones was assessed in a case-control study. The study included 250 cases with surgically or ultrasonographically confirmed cholecystolithiasis and 526 hospital control patients. The highest gallstone risk was found at low high-density cholesterol levels and high triglyceride levels. An additional weakly negative association was found between total cholesterol level and gallstone risk. These findings were similar for cholesterol gallstones and pigment gallstones. The association between body mass index and gallstone risk disappeared after adjustment for serum lipids in a multivariate analysis. This study confirms previous reports on the association between gallstone risk and serum lipids. The similarity between cholesterol and pigment gallstones with regard to their association with serum lipids indicates that these types of gallstones share more causal factors than previously suggested. The absence of an effect of body mass index independent from serum lipids (as shown by the multivariate analysis) suggests that serum lipids are more closely linked to the pathogenesis of gallstones than obesity.
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PMID:Serum lipids and gallstones: a case-control study. 237 87

To assess the prevalence of gallstone disease and the behavior of gallbladder (GB) volume in childhood and adolescence, an ultrasonographic survey was carried out on 1570 subjects (age range 6-19 yr). Entered in the study were 750 males and 752 females (attendance rate, 95.7%). Gallstones were detected in two females aged 13 and 18 yr, respectively. None of the subjects in the study population had undergone cholecystectomy. The overall prevalence of gallstone disease was equal to 0.13% (0.27% in the female sex). A positive family history for biliary calculous disease was present in one of the two lithiasic girls. A progressive increase of GB volume with age was observed in both sexes, and figures were greater in males, than in age-matched females. A positive and statistically significant relationship was found between GB volume and body mass index (BMI) in both sexes. Obesity was recognized in 188 males (25.3%) and 167 females (25.0%). Obese subjects exhibited larger GB volumes than the nonobese age- and sex-matched controls. The study supports the view of a very low prevalence of gallstone disease in people younger than 20. It also provides information on GB size in relation to age, sex, and BMI.
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PMID:Gallstone prevalence and gallbladder volume in children and adolescents: an epidemiological ultrasonographic survey and relationship to body mass index. 268 39

Gallstone disease has been recognized to be linked to others metabolic disorders such as obesity, atherosclerosis, hyperlipidemia and diabetes. Previous studies demonstrated a close relationship between abnormal eating habits and gallstone disease. The total caloric intake should be calculated on each individual energy requirement and should be restricted in over-weight patients. The diet should contain approximately 15-20% of the daily calories from proteins, 30-35% from fat (mainly vegetable fat for the higher content in polyunsaturated fat) and 40-55% from carbohydrate (especially complex carbohydrate). In addition the nutritional plan should consist of adequate amount of minerals and vitamins and the fiber consumption should be increased to 30-40 g/day. Finally, at last the Authors recommends (6279-8372 Kj- a regular subdivision of the meals (small and frequent) dressed in the very natural wag.
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PMID:[The dietary problem in cholelithiasis and patients at risk]. 295 22


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