Prevalence of Gall Stone Disease and its Relation to Hypercholesteraemia, Hypertension and Diabetes in Affluent North Indians: Population Based Study

Abstract

To investigate the prevalence of gall stone disease in the affluent north Indian population and to study its association with hypercholesteraemia, hypertension and diabetes, in isolation and together A survey of 1000 subjects who reported to the hospital for routine health check (including physical examination, routine blood investigations and abdominal ultrasound). Apollo Hospital, a private corporate hospital at New Delhi, India. 1000 subjects randomly selected, all above 20 yrs. of age; belonging to the higher socio-economic status in urban north India. We observed the prevalence of gall stones in our selected group to be 12% (n = 120). Of the 1000 people we studied, the percentage of gall stones in women (17.63%) was found to be significantly higher than that of men (9.02%) of any age group. Age in itself was found to be statistically significant for the presence of gall bladder stones with a definite increasing trend in the prevalence of stones with increasing age (24.1% in 70–80 yrs.). On differential studies in each gender, this significance was found to be relatively greater in males. Serum cholesterol levels were however not found to be statistically significant in the prevalence of gall bladder stones in our study (p = 0.423). However, when differential analysis was performed in each gender, we found serum cholesterol to be relatively more significant in males (p = 0.458) than females (p = 0.947). There was a positive co-relation (Pearson's correlate R = 0.115) between the prevalence of diabetes and gall stones that we observed in our data. This co-relation was observed to be even greater in males (p = 0.005) with diabetes in comparison to the corresponding females (p = 0.028). We found a higher percentage of people with co-morbid hypertension and gall bladder stone pathology (17.32%). The differential studies in each sex showed a much higher significance value for males (p = 0.022) over females (p = 0.082) with co-existing hypertension. The multi-variate analysis done for the same study group also revealed that raised serum cholesterol levels, though non-significant statistically on their own, were significant when co-existing with diabetes (p = 0.018). The other co-existing factors found to be statistically significant were diabetes with increasing age (p = 0.015); co-morbid diabetes, hypertension and hypercholesteraemia (p = 0.007); and diabetes with hypertension as well as hypercholesteraemia in the setting of increasing age (p = 0.001). Gall stone disease is one of the important lifestyle related diseases of today as observed by its high prevalence rate in our study, comparable to the rates in the western world[1,2]; with there being strong co-relations between the prevalence of gall stones and the other lifestyle diseases like diabetes, hypertension and hypercholestera • Studies from developing countries are not clear regarding the association between the total serum cholesterol and prevalence of gall stone disease [2,15]. • In urban north India, the prevalence of hypercholeateraemia and hypertension is high. • The prevalence of gall stone disease is higher among the people with hypertension or diabetes or with co-morbid hypercholesteraemia with hypertension.