Clinical Implications in the Incidence and Associated Risk Factors of Gallstone Disease Among Elderly Type 2 Diabetics in Kinmen, Taiwan

Abstract

This study was conducted to explore the incidence of and risk factors for gallstone disease (GSD) among elderly type 2 diabetic patients (aged 60 years or older) in Kinmen, Taiwan. In 2001, a panel of specialists performed ultrasound sonography screening on 594 elderly type 2 diabetic patients who were diagnosed in 1991–1993. The screening program involved 298 elderly type 2 diabetic patients. After excluding 51 participants with prevalent GSD, 247 participants without GSD were invited for a second round of screening in 2002. A total of 192 (77.7%) elderly participants were re-examined. Among the 192 elderly type 2 diabetic patients who had no GSD at the first round screening, eight patients had developed GSD by 2002, which is an incidence of 4.17% per year [95% confidence interval (CI) = 2.22–7.05% per year]. Using a stepwise Cox regression model, the waist circumference [relative risk (RR) =1.07; 95%CI = 1.01–1.18] and the alanine transaminase (ALT) level (RR = 1.10; 95%CI = 1.05–1.16) appeared to be significantly related to the development of GSD. Elderly type 2 diabetic patients had a slightly higher annual incidence of GSD, compared to the general population; however, the difference was not statistically significant. A greater waist circumference and high normal ALT levels were also associated with the development of GSD among this screened subpopulation.