Abstract
BackgroundAnimal experiments have shown a protective effect of vitamin C on the formation of gallstones. Few data in humans suggest an association between reduced vitamin C intake and increased prevalence of gallstone disease. The aim of this study was to assess the possible association of regular vitamin C supplementation with gallstone prevalence.MethodsAn observational, population-based study of 2129 subjects aged 18-65 years randomly selected from the general population in southern Germany was conducted. Abdominal ultrasound examination, completion of a standardized questionnaire, compilation of anthropometric data and blood tests were used. Data were collected in November and December 2002. Data analysis was conducted between December 2005 and January 2006.ResultsPrevalence of gallstones in the study population was 7.8% (167/2129). Subjects reporting vitamin C supplementation showed a prevalence of 4.7% (11/232), whereas in subjects not reporting regular vitamin C supplementation, the prevalence was 8.2% (156/1897). Female gender, hereditary predisposition, increasing age and body-mass index (BMI) were associated with increased prevalence of gallstones. Logistic regression with backward elimination adjusted for these factors showed reduced gallstone prevalence for vitamin C supplementation (odds ratio, OR 0.34; 95% confidence interval, CI 0.14 to 0.81; P = 0.01), increased physical activity (OR 0.62; 95% CI, 0.42 to 0.94; P = 0.02), and higher total cholesterol (OR 0.65; 95% CI, 0.52 to 0.79; P < 0.001).ConclusionRegular vitamin C supplementation and, to a lesser extent, increased physical activity and total cholesterol levels are associated with a reduced prevalence of gallstones. Regular vitamin C supplementation might exert a protective effect on the development of gallstones.
Highlights
Animal experiments have shown a protective effect of vitamin C on the formation of gallstones
A total of 167 persons fulfilled the criteria for gallstone disease, corresponding to an overall prevalence of 7.8% (167/2129) (Table 1)
Separate multiple regression analyses showed a reduced prevalence of gallstones for each of the following factors: regular vitamin C supplementation, alcohol consumption, leisure time physical activity, elevated total cholesterol, Low-density lipoprotein (LDL) cholesterol, and high-density lipoprotein (HDL) cholesterol levels
Summary
Animal experiments have shown a protective effect of vitamin C on the formation of gallstones. Few data in humans suggest an association between reduced vitamin C intake and increased prevalence of gallstone disease. Clinical and experimental data reported in the 1970's suggested a potential protective effect of vitamin C on the formation of gallstones [3,4]. Animal experiments have shown that animals deficient in vitamin C more frequently develop gallstones [5,6]. Vitamin C increases the rate of 7αhydroxylation of cholesterol [4,7,8] This reaction is decreased in ascorbic acid deficiency, resulting in reduced bile acid biogenesis [4,9]. Ascorbic acid deficient animals more frequently developed cholesterol gallstones [5,6]
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