The prevalence of gallstones in chronic liver disease is related to degreeof liver dysfunction

BACKGROUND/AIMS: Earlier studies have indicated an elevated risk for gallst one disease in patients with cirrhosis. This study aimed to evaluate the pr evalence of gallstones in patients with chronic liver disease (CLD) with re spect to sex, etiology, and severity of liver disease. METHODOLOGY: Four hundred and thirteen adults (176 women), mean age 51.2+/- 14 years, with CLD, who had undergone liver biopsy during 1978-1993, and fr om whom sera were available, were investigated retrospectively. The results were compared with a population-based ultrasonography study of 556 healthy men and women, in their 40s and 60s. RESULTS: The prevalence of gallstones in patients with CLD did not differ f rom that in the control population. An increased frequency was observed in patients with CLD initially classified as cryptogenic, of whom the majority (60%) later were reclassified as chronic hepatitis C. The frequency of gal lstones was also high in PiZ-heterozygotes for alpha(1)-antitrypsin deficie ncy (5/21, 24%) compared to non-PiZ-carriers (17/389, 4.8%), (p<0.001). In 67 patients with histologic evidence of cirrhosis, 30% (20/67) had gallston es (vs. 15% in the general population, p<0.01). The prevalence of gallstone s increased significantly from Child's class A (16%) to C (56.2%). The diff erence was significant in males (18.2% vs. 62.5%, p=0.033), but not in fema les. Fifty percent of the patients with gallstones were symptomatic. CONCLUSIONS: Progressive Liver dysfunction is a risk factor for gallstones particularly in males. HCV infection and PiZ carriership may further increa se biliary lithogenesis.