Clinical Research
Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Sep 14, 2008; 14(34): 5282-5289
Published online Sep 14, 2008. doi: 10.3748/wjg.14.5282
Incidence of gallstone disease in Italy: Results from a multicenter, population-based Italian study (the MICOL project)
Davide Festi, Ada Dormi, Simona Capodicasa, Tommaso Staniscia, Adolfo F Attili, Paola Loria, Paolo Pazzi, Giuseppe Mazzella, Claudia Sama, Enrico Roda, Antonio Colecchia
Davide Festi, Giuseppe Mazzella, Claudia Sama, Enrico Roda, Antonio Colecchia, Department of Internal Medicine and Gastroenterology, University of Bologna, Bologna 40138, Italy
Ada Dormi, Department of Clinical Medicine and Biotech-nology, University of Bologna, Bologna 40138, Italy
Simona Capodicasa, Tommaso Staniscia, Department of Medicine and Aging, University of Chieti, Chieti 66100, Italy
Adolfo F Attili, Department of Gastroenterology, University “La Sapienza”, Roma 00010, Italy
Paola Loria, Department of Internal Medicine, University of Modena, Modena 41100, Italy
Paolo Pazzi, Department of Internal Medicine, S. Anna Hospital, Ferrara 44100, Italy
Author contributions: Festi D, Attili AF, Pazzi P, Loria P, Sama C, Roda E designed research; Festi D, Attili AF, Pazzi P, Loria P, Colecchia A performed research; Capodicasa S, Staniscia T, Dormi A analyzed data; Festi D wrote the paper.
Correspondence to: Davide Festi, MD, Dipartimento di Medicina Interna e Gastroenterologia, Policlinico S. Orsola-Malpighi, Via Massarenti 9, Bologna 40138, Italy.
Telephone: +39-51-6364123 Fax: +39-51-6364123
Received: January 3, 2008
Revised: August 13, 2008
Accepted: August 20, 2008
Published online: September 14, 2008

AIM: To evaluate gallstone incidence and risk factors in a large population-based study.

METHODS: Gallstone incidence and risk factors, were evaluated by structured questionnaire and physical examination, respectively, in 9611 of 11 109 (86.5%) subjects who were gallstone-free at the cross-sectional study.

RESULTS: Six centers throughout Italy enrolled 9611 subjects (5477 males, 4134 females, aged 30-79 years), 9517 of whom were included into analysis: 424 subjects (4.4%) had gallstones and 61 (0.6%) had been cholecystectomized yielding a cumulative incidence of 0.67% per year (0.66% in males, 0.81% in females). Increasing age, a high body mass index (BMI), a history of diabetes, peptic ulcer and angina, and low cholesterol and high triglyceride levels were identified as risk factors in men while, in females, the only risk factors were increasing age and a high BMI. Increasing age and pain in the right hypochondrium in men and increasing age in females were identified as predictors of gallstones. Pain in the epigastrium/right hypochondrium was the only symptom related to gallstones; furthermore, some characteristics of pain (forcing to rest, not relieved by bowel movements) were significantly associated with gallstones. No correlation was found between gallstone characteristics and clinical manifestations, while increasing age in men and increasing age and BMI in females were predictors of pain.

CONCLUSION: Increasing age and BMI represent true risk factors for gallstone disease (GD); pain in the right hypochondrium and/or epigastrium is confirmed as the only symptom related to gallstones.

Keywords: Gallstone disease, Ultrasonography, Epidemiology, Prevalence, Incidence, Abdominal pain, Cholecystectomy, Body mass index