RISK OF ASYMPTOMATIC AND SYMPTOMATIC GALLSTONES IN MODERATELY OBESE WOMEN - A LONGITUDINAL FOLLOW-UP-STUDY

Obesity is a rather documented risk factor for the formation of gallst ones (GS) in women. The magnitude of the increased risk and the rates of GS occurrence, however, have not been well quantified, except for t wo studies on the risk of symptomatic stones in obese women. We analyz ed the incidence of GS in 157 moderately obese women (body mass index, 31.4 +/- 3.6 kg/ m(2)) followed up prospectively by ultrasound for 2- 6 yr (mean 3.95 yr). Women with morbid obesity (body mass index >40 kg /m(2)) were excluded from the study, as well as patients having diseas es with lithogenic risk. All the enrolled women had normal cholecystos onogram results at the beginning of the study. Age, family history of GS or obesity, parity, age of obesity onset, hyperlipoproteinemia type , plasma cholesterol (total, HDL, LDL), and triglycerides were assesse d. The Student's t, the Mann-Whitney rank sum and the Fisher's exact t ests were used, as well as the multiple logistic regression for the mu ltivariate analysis. During the survey, 16 of 157 women (10.2%) develo ped GS. GS were asymptomatic in 11 persons (68.8%). The cumulative inc idence of both asymptomatic and symptomatic GS was 2.6 cases/100 obese women year. During the follow-up, most of the detected GS were asympt omatic, and this explains the higher GS incidence rate found compared with that previously calculated for symptomatic GS. The following risk factors were associated with GS formation: age (p = 0.002), family hi story of GS (p = 0.011), early obesity onset (p = 0.003), and hyperlip oproteinemia type IV (p = 0.011). A high risk class might be thus iden tified among obese women, offering a more realistic approach for the p rimary prophylaxis of GS.