Risk Factors For Gallstone Disease Research Articles

Pathophysiological connections between gallstone disease, insulin resistance, and obesity.

Obesity and cholesterol gallstone disease (GSD) are frequently coexisting diseases; therefore and considering the current worldwide obesity epidemics, a precise understanding of the pathophysiological relationships between GSD and insulin resistance (IR) is important. Classically, obesity has been understood as a risk factor for GSD and the gallbladder (GB) viewed as a simple bile reservoir, with no metabolic roles whatsoever. However, consistent evidence has showed that both GSD and cholecystectomy associates with fatty liver and IR, raising the possibility that the GB is indeed an organ with metabolic regulatory roles. Herein, we review the pathophysiological mechanisms by which GSD, IR, and obesity are interconnected, with emphasis in the actions of the GB as a regulator of bile acids kinetics and a hormone secreting organ, with metabolic actions at the systemic level. We also examine the relationships between increased hepatic lipogenic in IR states and GSD pathogenesis. We propose a model in which GSD and hepatic IR mutually interact to determine a state of dysregulated lipid and energy metabolism that potentiate the metabolic dysregulation of obesity.

The grade of nonalcoholic fatty liver disease is an independent risk factor for gallstone disease: An observational Study.

There have been reports linking nonalcoholic fatty liver disease (NAFLD) with gallstone disease (GD) owing to shared risk factors. However, there are no reported associations between the different NAFLD grades and GD. This study aimed to determine whether NAFLD grade is an independent risk factor for GD in a Korean population.This study enrolled 7886 participants who completed a questionnaire and underwent medical examination and ultrasound scanning at the Health Promotion Center of Jeju National University Hospital in Korea, from January 2009 to December 2017. Fatty liver grading and presence of gallstones were investigated using abdominal ultrasound. Body mass index and biochemical parameters were measured, and age, sex, and metabolic syndrome status were collected from medical records. Univariate and multivariate analyses were performed to identify risk factors for GD.The estimated prevalences of NAFLD and GD were 40.6% and 4.5%, respectively. In the univariate analysis, factors associated with GD were age; NAFLD; presence of metabolic syndrome; and levels of fasting blood glucose, high-density lipoproteins, aspartate aminotransferase, and alanine aminotransferase. Multivariate logistic regression analysis revealed older age and higher NAFLD grade as independent risk factors for GD.Older age and higher grade of NAFLD were independent risk factors for GD in our cohort. There was a strong correlation between grade of NAFLD on abdominal ultrasonography and GD.

A Clinical Study of Cholelithiasis at a Tertiary Health Care Centre

Introduction: Cholelithiasis is the most common disease state involving the gallbladder and biliary tree. Gallstones become symptomatic only when they obstruct a visceral structure. In developing countries, there exists a trend toward an increasing prevalence of the risk factors for gallstone disease. Materials and Methods: Cases were selected after applying inclusion and exclusion criteria. Thereafter data collection was done by meticulous history taking, clinical examination, appropriate laboratory and radiological investigations, operative findings, and post operative evaluation of cases. Results: This study comprised of 52 cases. Female to male ratio was 15:11. The most common presenting complaint was pain in abdomen in 49 (94.23%) patients. On clinical examination most common sign was tenderness in 48 (92.31%) patients. Abdominal ultrasonography showed gallstones in all cases. Either laparoscopic or open cholecystectomy was performed. Complications included wound infection, haemorrhage, and bile duct injury. On histo-pathological examination the most common finding was chronic Cholecystitis seen in 39 (75.00%) cases. Conclusion: The incidence of disease was more in females. The most common complaint was pain and the most common sign was tenderness. Abdominal ultrasonography should be imaging study of choice for suspected cases of cholelithiasis. Laparoscopic cholecystectomy is the procedure of choice.

Analysis of gallstone disease risk factors using samples from patients after cholecystectomy at Republic hospital №1 -NCM surgical ward (Yakutsk)

Analysis of gallstone disease risk factors using samples from patients after cholecystectomy at Republic hospital №1 -NCM surgical ward (Yakutsk)

Bariatric Surgery Did Not Increase the Risk of Gallstone Disease in Obese Patients: a Comprehensive Cohort Study.

The aim of this study was to evaluate the influence of bariatric surgery on gallstone disease in obese patients. This large cohort retrospective study was conducted based on the Taiwan National Health Insurance Research Database. All patients 18-55years of age with a diagnosis code for obesity (ICD-9-CM codes 278.00-278.02 or 278.1) between 2003 and 2010 were included. Patients with a history of gallstone disease and hepatic malignancies were excluded. The patients were divided into non-surgical and bariatric surgery groups. Obesity surgery was defined by ICD-9-OP codes. We also enrolled healthy civilians as the general population. The primary end point was defined as re-hospitalization with a diagnosis of gallstone disease after the index hospitalization. All patients were followed until the end of 2013, a biliary complication occurred, or death. Two thousand three hundred seventeen patients in the bariatric surgery group, 2331 patients in the non-surgical group, and 8162 patients in the general population were included. Compared to the non-surgery group (2.79%), bariatric surgery (2.89%) did not elevate the risk of subsequent biliary events (HR = 1.075, p = 0.679). Compared to the general population (1.15%), bariatric surgery group had a significantly higher risk (HR = 4.996, p < 0.001). In the bariatric surgery group, female gender (HR = 1.774, p = 0.032) and a restrictive procedure (HR = 1.624, p = 0.048) were risk factors for gallstone disease. The risk for gallstone disease did not increase after bariatric surgery, although the risk was still higher than the general population. The benefit of concomitant cholecystectomy during bariatric surgery should be carefully evaluated.

Appropriateness of liver biopsy for nonalcoholic fatty liver disease in obese patients during laparoscopic cholecystectomy for gallstone disease

Background and aims: Obesity is well known as a risk factor for gallstone disease and is also a risk factor for fatty liver. Before laparoscopic cholecystectomy, it is not easy to detect fatty liver, except for severe fatty liver. Liver biopsy is invasive and is not recommended except in special cases, but is not a relatively risky procedure during laparoscopic cholecystectomy. Therefore, we validated the efficacy of liver biopsy in obese patients during laparoscopic cholecystectomy for gallstone disease. Materials and methods: We retrospectively reviewed medical records in obese patients with gallstone disease who underwent laparoscopic cholecystectomy with liver biopsy. The definition of obesity was based on the Asian obesity criteria. (overweight :23∼24.9, obese class I :>25, & obese class II >30). Total 74 patients were included, and 30 patients were diagnosed as fatty liver (A) and compared with patients without fatty liver disease (B) using various parameters. Results: There were 9 male and 21 female in fatty liver group and 18 male and 26 female without fatty liver. In the fatty liver group, 6 overweight, 19 obese class I, & 5 obese class II, but in the group without fatty liver, 21 overweight, 19 obese class I, & 4 obese class II. The degree of obesity in the fatty liver group was more severe(p=.022). Except level of aminotransferase, all biochemical parameters were not different between two groups. Conclusion: The liver biopsy could be recommended in obese I & II patients with abnormal levels of aminotransferase.

Prevalence and Risk Factors for Gallstone Disease in Hail Region

Aim of the work: this study was carried out to determine the prevalence and risk factors of the occurrence of gallstone disease among the Saudi Arabian population. Patients and methods: a retrospective survey was done among 100 patients with gallstone disease from November 2016 to March 2017 using a structured data collection tool. Results: The results showed that 60% of those with the disease were women, while only 40% were men and 29% belonged to age group 30-39 years old. Among the risk factors studied, there was a statistically significant association between the disease and fever and lipid profile, total cholesterol, LDL, and TAG (p-value,<.01). In addition to fever, majority of the patients also complained for right upper quadrant pain. Perhaps primary health care physicians should consider fever with right upper quadrant pain as warning signs for gallstone disease which should warrant more sensitive procedures like ultrasonography for early detection of the disease. Fundamental knowledge of gallstone disease is essential for clinicians so as proper management be offered to ailing patients.

Prevalence and Risk Factors for Gallstone Disease in Hail Region

Prevalence and Risk Factors for Gallstone Disease in Hail Region

Associations between serum leptin levels, hyperlipidemia, and cholelithiasis in dogs.

Leptin and its receptor play several physiological roles in the canine gallbladder, and the dysregulation of leptin might play a role in the pathogenesis of gallbladder diseases such as gallbladder mucocele. Previous studies revealed a positive association between hyperlipidemia and gallstones in humans. However, the latter is still unclear in dogs with cholelithiasis. In this study, we examined the differences in leptin, leptin receptor, total cholesterol, and triglyceride levels between healthy dogs and dogs with cholelithiasis, and evaluated the correlation between leptin and hyperlipidemia. Twenty-eight healthy dogs and 34 client-owned dogs with cholelithiasis were enrolled in the study. Leptin concentrations and lipid profiles were determined from sera, and leptin and leptin receptor expression levels were quantified in gallbladder tissue. In dogs with cholelithiasis, serum concentrations of leptin (p < 0.001), total cholesterol (p < 0.001), and triglycerides (p < 0.001) were significantly higher compared with those in healthy dogs. Positive correlations were observed between serum leptin and total cholesterol (95% confidence interval (CI) = 0.61–0.89, r = 0.725, p < 0.001), and between leptin and triglycerides (95% CI = 0.63–0.89, r = 0.782, p < 0.001) in the cholelithiasis group. Hypercholesterolemia (Odds Ratio (OR) = 9.720; 95% CI = 1.148–82.318) and hypertriglyceridemia (OR = 12.913; 95% CI = 1.548–107.722) were shown to be risk factors for gallstone disease. In cholelithiasis patients who underwent cholecystectomy, serum leptin levels were significantly higher than in patients that had not undergone surgery (p < 0.001). Leptin and leptin receptor expression was upregulated in the gallbladder tissues of cholelithiasis patients (p < 0.01 and p < 0.001, respectively). These results indicate that increased serum leptin concentrations and hyperlipidemia (hypercholesterolemia or hypertriglyceridemia) are associated with canine cholelithiasis and that homeostatic imbalance of these parameters might affect the pathogenesis of gallstones.

Prevalence and Risk Factors for Gallstones among Population in Riyadh City, KSA 2017

Background: The most common risk factors for gallstones formations are old age, female gender, obesity and diabetes mellitus. However, information about the prevalence and significant risk factors in Kingdom of Saudi Arabia (KSA) are limited. Objectives: Evaluating the prevalence and risk factors of gallstone disease among Saudi population in Riyadh, Kingdom of Saudi Arabia (KSA). Methods: A cross sectional study that included 500 subjects adult Saudi population who were randomly chosen from February –June 2017. The volunteers were subjected to clinical evaluation, laboratory investigations and ultrasound examination. Results: The overall prevalence of gallstone disease was 8.6%. The older age, female gender, physical activities and obesity are key factors in the gallstones progression. Also, diabetes, liver enzymes and the lipid profile were modifiable risk factors for gallstones. Conclusion: The risk factors for gallstones formation are old age, female gender, physical activities and obesity were key factors in the gallstones progression.

Epidemiological, demographic and risk factor profile in patients harbouring various types of gallbladder calculi: a cross sectional study from a south Indian tertiary care hospital

Background: Gallstone disease is one of the most common digestive system diseases next to GERD and accepted treatment involves laparoscopic or open cholecystectomy making it one of the costly diseases. with increasing westernisation of Indian lifestyle and food and also recent studies pointing out its association with cardiovascular disease and cancer mortality its need of the time to undertake an extensive study on epidemiology, demography and risk factors of gallstone disease. The aim was to study the epidemiological, demographic and risk factor profile in patients harbouring various types of gallbladder calculi.Methods: A cross sectional prospective study was conducted. 100 cholelithiasis patients were undergoing operative procedure at our department.Results: Showed that females had higher incidence of gallstone disease with a ratio of 2:1, mixed gallstone was the predominant type (53%), mean BMI of the study population was 28.03 with SD of 3.61.Conclusions: Women are twice as likely as men to form gallstones. Most common gallstone type found is mixed type and least is cholesterol type. Age group most commonly affected is between 31-50 years. There is a statistically significant association between high BMI and occurrence of gallstone. There is a statistically significant association between diabetes and occurrence of gallstone.

Gallstones and Bariatric Surgery: To Treat or Not to Treat?

Obesity and rapid weight loss after bariatric surgery are risk factors for gallstone disease. The present study sought to evaluate the feasibility of selective concomitant cholecystectomy only in patients with symptomatic disease and study risk factors for the development of symptomatic gallstones after bariatric surgery. Between January 2010 and December 2012, 734 consecutive patients presenting to our institution underwent bariatric surgery. From these, 81 patients were excluded due to prior or concurrent cholecystectomy. The remaining 653 patients with in situ gallbladder were followed for 12months and were clinically screened for symptomatic or complicated cholelithiasis. Clinical and demographic characteristics were compared at baseline and 12months after surgery. Of the 653 patients with in situ gallbladder, only 24 (3.3%) developed symptomatic gallstones and only nine presented complicated disease. None of the patients with asymptomatic disease at the time of surgery progressed to symptomatic or complicated disease. Patients who developed symptomatic disease were not significantly different, although there was a trend toward longer obesity evolution, lower insulin levels, and lower hepatic enzymes level. A multivariate regression analysis revealed that patients with gastric sleeve were more likely to develop symptomatic gallstones. Although further studies are required, the management of gallstones in morbidly obese patients should not be different from normal-weight patients. Therefore, performing a laparoscopic cholecystectomy only in symptomatic patients is an effective approach and asymptomatic gallstones should not be treated at the time of bariatric surgery.

Risk factors of cholelithiasis in China: a Meta-analysis

Objective To investigate the risk factors of Gallstone Disease (GD) by a meta-analysis, which hopefully will help to develop a strategy for its prevention. Methods Thirty case-control studies on risk factors of GD in Chinese patients reported from 1987 to 2014 were included. A quantitative comprehensive analysis and a heterogeneity test were conducted and the OR value and its 95% confidence interval (CI) were calculated by using Stata 12.0. Results A family history of GD [OR(95%CI): 2.73(2.22~3.35)], alcohol drinking [OR(95%CI): 1.53(1.20~1.97)], a history of biliary tract roundworm [OR(95%CI): 5.28(3.10~9.00)], a history of biliary tract infection [OR(95%CI): 28.50(19.22~42.26)], a BMI≥25 kg/m2 [OR(95%CI): 1.70(1.51~1.92)], greasy food intake [OR(95%CI): 3.27(1.76~6.07)], a non-vegetarian diet [OR(95%CI): 2.03(1.48~2.77)], hyperlipidemia [OR(95%CI): 2.26(1.88~2.71)], menopause [OR(95%CI): 3.25(2.49~4.24)] and multiple pregnancies [OR(95%CI): 1.56(1.29~1.88)] were risk factors of GD in China. Besides, milk drinking [OR(95%CI): 0.43(0.34~0.55)] and regular breakfast [OR(95%CI): 0.19(0.06~0.64)] were protective factors of GD. Tea drinking [OR(95%CI): 0.43(0.34~0.55)], smoking [OR(95%CI): 0.86(0.51~1.45)], and a vegetarian diet [OR(95%CI): 0.24(0.05~1.13)] were possible GD’s protective factors as they were not statistically significant. Conclusion Having breakfast, drinking milk, keeping fit, less alcohol and avoiding Ascaris infection prevent the occurrence of GD in China. Key words: Cholelithiasis; Risk Factors; Meta-analysis; China

The Association between Metabolic Syndrome Combined with Fatty Liver Disease and Gallstone Disease—Data Analysis of Health Examinations

Backgroundi¼sIn Taiwan, the prevalence rate of gallstone disease (GD) is estimated to be 5%-10% among adults. Several reports have suggested that females and old age individuals have a higher prevalence rate of GD. In addition, hyperglycemia, dyslipidemia and obesity, which are common features of metabolic syndrome, are risk factors for GD. Few studies have examined the relationship between metabolic syndrome combined with fatty liver disease and gallstone disease. Purpose: This study aimed to investigate the relationship between metabolic syndrome combined with fatty liver disease and gallstone disease. Methods: This study applied cross-sectional data analysis. Participants received physical examination at a local hospital in Kaohsiung, Taiwan, from 2011 to 2014. Fatty liver disease and gallstone disease were diagnosed by a gastroenterologist with abdominal ultrasonography. The metabolic syndrome was defined according to the standards set by Health Promotion Administration, Ministry of Health and Welfare, in 2007. Physical examination and blood test results were employed to evaluate the prevalence rate and risk factors of gallstone disease.Results: The results indicated that prevalence rate of GD was 5%. GD had a significantly higher prevalence among participants aged 40 years and older than those under 40 years old. GD prevalence rate was higher among participants with abnormalities associated with metabolic syndrome and its components than healthy participants. GD prevalence rate was significantly higher among participants with mild or moderate fatty liver combined with metabolic syndrome than those without the metabolic syndrome or with a different degree of fatty liver disease. Participants aged 40 years and older had a 2.88-fold higher risk of getting GD than those who were under 40 years old. The risk of GD increased 1.70-fold in participants with mild fatty liver disease combined with metabolic syndrome and 1.32-fold in participants with moderate fatty liver disease combined with metabolic syndrome. Conclusion: Prevalence and risk of GD is significantly higher in participants with metabolic syndrome. Awareness of GD prevalence rate and risk factors can facilitate effective GD prevention.

Hepatitis C Virus Infection Is Positively Associated with Gallstones in Liver Cirrhosis

Aim: To elucidate the prevalence and risk factors of gallstone disease (GD) among patients with liver disease and explore their association with the aetiology and severity of hepatic injury. Methods: We analysed 4,832 subjects of hepatic injury induced by one of the following aetiologies: hepatitis B virus (HBV) infection, hepatitis C virus (HCV) infection, excessive alcohol consumption. The risk factors significantly associated with GD were analysed using stepwise logistic regression analysis, the influence of aetiology and severity of liver disease on the prevalence of GD were assessed by multiple logistic regression analysis adjusting for confounding factors. Results: Three thousand forty eight patients were of positive HBV surface antigen alone with a prevalence of GD of 18.6%, 526 were tested as positive Anti-HCV alone with a prevalence of GD of 22.4%, and 1,258 were identified with excessive alcohol consumption patterns with a prevalence of GD of 13.5%. In each aetiological category, the prevalence of GD increased by age. Stepwise logistic regression analysis showed that age, female, low-density lipoprotein-cholesterol (LDL-Cho), family history of GD, HBV infection, HCV infection, chronic hepatitis and cirrhosis were independent associated with HCV-related cirrhosis in both genders, HBV-related cirrhosis in males and alcohol-related cirrhosis in females compared with patients with less severe liver disease. After adjusting for gender, age, LDL-Cho and family history of GD, patients with HCV-related cirrhosis (OR 2.66, 95% CI 1.49-3.84) but not HBV-related cirrhosis (OR 1.52, 95% CI 0.73-1.82) were more likely to have GD compared with alcohol-related cirrhosis. Conclusion: HCV infection is positively associated with gallstone formation especially in those with cirrhosis patients.

Four Susceptibility Loci for Gallstone Disease Identified in a Meta-analysis of Genome-Wide Association Studies

A genome-wide association study (GWAS) of 280 cases identified the hepatic cholesterol transporter ABCG8 as a locus associated with risk for gallstone disease, but findings have not been reported from any other GWAS of this phenotype. We performed a large-scale, meta-analysis of GWASs of individuals of European ancestry with available prior genotype data, to identify additional genetic risk factors for gallstone disease. We obtained per-allele odds ratio (OR) and standard error estimates using age- and sex-adjusted logistic regression models within each of the 10 discovery studies (8720 cases and 55,152 controls). We performed an inverse variance weighted, fixed-effects meta-analysis of study-specific estimates to identify single-nucleotide polymorphisms that were associated independently with gallstone disease. Associations were replicated in 6489 cases and 62,797 controls. We observed independent associations for 2 single-nucleotide polymorphisms at the ABCG8 locus: rs11887534 (OR, 1.69; 95% confidence interval [CI], 1.54-1.86; P= 2.44× 10(-60)) and rs4245791 (OR, 1.27; P= 1.90× 10(-34)). We also identified and/or replicated associations for rs9843304 in TM4SF4 (OR, 1.12; 95% CI, 1.08-1.16; P= 6.09× 10(-11)), rs2547231 in SULT2A1 (encodes a sulfoconjugation enzyme that acts on hydroxysteroids and cholesterol-derived sterol bile acids) (OR, 1.17; 95% CI, 1.12-1.21; P= 2.24× 10(-10)), rs1260326 in glucokinase regulatory protein (OR, 1.12; 95% CI, 1.07-1.17; P=2.55× 10(-10)), and rs6471717 near CYP7A1 (encodes an enzyme that catalyzes conversion of cholesterol to primary bile acids) (OR, 1.11; 95% CI, 1.08-1.15; P= 8.84× 10(-9)). Among individuals of African American and Hispanic American ancestry, rs11887534 and rs4245791 were associated positively with gallstone disease risk, whereas theassociation for the rs1260326 variant was inverse. In this large-scale GWAS of gallstone disease, we identified 4 loci in genes that have putative functions in cholesterol metabolism and transport, and sulfonylation of bile acids or hydroxysteroids.

AGE AND GENDER PECULIARITIES OF DEVELOPMENT OF GALLSTONE DISEASE

Goal. Study of the role of risk factors in mechanized gall stone formation depending on sex and age of patients. Material and methods We examined 210 patients with stage I gallstone disease (GSD). In verification of diagnosis used an ultrasound study of the hepatobiliary system, multi-grade duodenal sounding with subsequent macroscopic, microscopic, chemical and physical examination of bile. In the portions “b” and “C” bile was determined the total concentration of bile acids, cholesterol, with the subsequent calculation it consists of cholesterol ratio. Estimation of surface tension of bile viscosity and bile. In the studied blood levels of total cholesterol, lipoproteins of very low density, lowdensity lipoproteins, high density lipoproteins, triglycerides, were determined the coefficient of atherogenicity. To assess the degree of accumulation of body fat was used the Quetelet index. Studied the relative risk of anamnestic risk factors of GSD. Results. The features of biliary lithogenesis based on gender and age of patients. High value PR for the gall stone formation are female gender — 3,16, Mature and elderly age (older than 50) of 3.67. In young women, gall-stone formation is mainly due to the increase of cholesterol level of bile, at the age of 50 years with a decline in zhelchnokamennaja pool, increased viscosity and surface tension of bile. The most important risk factors of cholecystolithiasis are also gender differences: if women is multiple pregnancies and (or) childbirth (more than 3) — OR 4,62, overweight (BMI over 26) — OR is 4.57 and the violation of the principles of good nutrition (eating disorders, overeating or starvation, the use of large quantities of animal fats) — OR 3,94, for men it’s physical inactivity — OR a 4.25, the increase in KA — PR 3.87 and burdened by GSD genetics — OR of 2.05. Conclusion. The data obtained can be used in the organization of dispensary work with patients with hepatobiliary pathology, and to optimize primary prevention of gall stone formation.

P512. The prevalence and risk factors of gallstone disease in patients with ulcerative colitis

P512. The prevalence and risk factors of gallstone disease in patients with ulcerative colitis

The Prevalence and Risk Factors of Gallstone Among Adults in South-East of Iran: A Population-Based Study.

Objective:The present study aimed to evaluate the prevalence and possible risk factors of gallstone disease in the general population.Patients and Methods:This cross sectional study was carried out on a total of 1522 males and females aged ≥30 years in Zahedan district, South-East of Iran. Data were collected by a validated questionnaire and gallstone diagnosis was assessed by an experienced radiologist using ultrasonography. Logistic regression model was used to identify the association between selected variables and gallstone disease.Results:The overall prevalence of gallstone in participants was 2.4%. The risk of gallstone was 2.60 times higher in people age 45 and older than those aged 30 - 44 years (Odds Ratio = 2.60, 95% CI; 1.22 - 5.55). Females were 2.73 (95% CI; 1.34 - 5.56) times more likely to have disease compared to males as well. The risk in unmarried individuals was also three times higher than married ones (OR = 2.99: 95% CI 1.02 - 9.16). Additionally, daily physical activity reduced the risk of gallstone disease by 66% (95% CI; 0.18 - 0.86).Conclusion:In conclusion, increasing age and female gender were risk factors, whereas daily physical activity and marriage identified as protective factors in aetiology of gallstone disease.

Abdominal visceral fat accumulation measured by computed tomography associated with an increased risk of gallstone disease.

Visceral adiposity is a strong determinant of insulin resistance, which decreases cholecystokinin response sensitivity, and increases cholesterol saturation in the gallbladder bile; thus, it potentially relates to gallstone disease development. We aimed to investigate whether visceral fat measured by computed tomography (CT) is a risk factor for gallstone disease. A cohort of 717 participants undergoing CT and ultrasonography was analyzed. The associations between body mass index (BMI), visceral adipose tissue (VAT) area, subcutaneous adipose tissue (SAT) area, and gallstone disease were analyzed adjusted for age, sex, hypertension, diabetes, and dyslipidemia. In multivariate analysis, gallstone disease was significantly associated with VAT and SAT areas for both categorical data and trend (P for trend < 0.001, 0.009), but not body mass index (BMI). Among patients with BMI < 25, gallstone disease remained significantly associated with VAT area (P for trend 0.021) and SAT area (P for trend 0.005). Interactions between the obesity indices and being elderly on the risk of gallstone disease were found; specifically BMI (P = 0.005), SAT (P < 0.001), and VAT (P = 0.154). A significant association between all obesity indices and gallstone disease was seen in patients aged < 65 but not among those aged ≥ 65. However, no significant association was noted between the obesity indices and sex. CT-measured adipose tissue, rather than BMI, was a better predictor for risk of gallstone disease. This finding applies to younger people or even those with normal body weight, suggesting the importance of abdominal visceral fat accumulation in the development of gallstone disease.