Incidence of gallstone disease in Italy: Results from a multicenter, population-based Italian study (the MICOL project)

Table 1 Incidence of GD in the different operative units of the MICOL project

Operative unit	Overall % yr	Male	Female
Bologna Loiano	0.50	0.50	0.50
Bologna Brisighella	0.61	0.60	0.80
Bolzano	0.82	0.50	1.10
Castellana Grotte	0.75	0.70	0.80
Tivoli	0.64	0.50	0.70
Modena San Lazzaro	0.43	0.40	0.40
Modena Madonnina	0.86	0.60	1.20
Overall	0.67	0.66	0.81

Table 2 Characteristics of newly developed gallstones

Characteristics		%	P
Overall
Number	Single	48.90	< 0.0001
	Multiple	51.10
Size	≤ 1.5 cm	77.90	< 0.0001
	≥ 1.5 cm	22.10
Male
Number	Single	44.80	< 0.0001
	Multiple	55.20
Size	≤ 1.5 cm	78.70	< 0.0001
	≥ 1.5 cm	21.30
Female
Number	Single	52.30	< 0.0001
	Multiple	47.70
Size	≤ 1.5 cm	77.10	< 0.0001
	≥ 1.5 cm	22.90

Table 3 Risk factors for GD

Factor	Coefficient	SE	P
Men
Age	0.0405	0.0071	< 0.000
BMI	0.0536	0.0195	< 0.006
HDL cholesterol	-0.0118	0.0059	< 0.040
Cholesterol	-0.0034	0.0016	< 0.030
Triglycerides	0.0004	0.0001	< 0.007
Diabetes	0.5293	0.2220	< 0.010
Peptic ulcer	0.4378	0.1753	< 0.010
Women
Age	0.0279	0.0073	< 0.000
BMI	0.0178	0.0147	< 0.000

Logistic regression analysis: regression coefficients, corresponding SE, and P values for single factors and interactions, significantly associated with gallstones.

Table 4 Risk factors for GD

Factor OR (95% CI)	Gallstones not previously diagnosed (n = 312)	Gallstones previously diagnosed (n = 112)	Cholecystectomized (n = 61)
Men
Age	1.03 (1.01-1.05)	1.05 (1.02-1.07)	1.01 (0.97-1.06)
BMI	1.06 (1.01-1.11)	1.03 (0.97- 1.10)	1.07 (0.96-1.06)
HDL cholesterol	0.99 (0.97-1.004)	0.98 (0.96-1.00)	1.00 (0.97-1.03)
Cholesterol	0.99 (0.99-1.00)	0.99 (0.98-0.99)	1.00 (0.99-1.01)
Triglycerides	1.00 (0.99-1.00)	1.00 (1.00-1.01)	0.99 (0.99-1.00)
Diabetes	1.75 (1.04-2.96)	1.60 (0.77-3.32)	2.72 (0.89-8.33)
Peptic ulcers	1.11 (0.69-1.77)	2.53 (1.52-4.20)	3.38 (1.48-7.72)
Myocardial infarction	0.99 (0.99-1.00)	1.27 (0.38-4.23)	1.43 (0.18-11.18)
Women
Age	1.01 (1.00-1.03)	1.04 (1.02-1.07)	0.98 (0.94-1.02)
BMI	1.08 (1.04-1.12)	1.05 (1.00-1.11)	1.07 (0.99-1.15)
HDL cholesterol	1.00 (0.99-1.01)	0.98 (0.97-1.00)	0.98 (0.95-1.00)
Cholesterol	0.99 (0.99-1.00)	1.00 (0.99-1.00)	1.00 (1.00-1.01)
Triglycerides	1.00 (0.99-1.00)	0.99 (0.99-1.00)	0.99 (0.99-1.00)
Diabetes	1.10 (0.58-2.09)	0.48 (0.14-1.58)	1.00 (0.22-4.49)
Peptic ulcers	0.67 (0.34-1.34)	0.70 (0.28-1.76)	3.55 (1.57-8.04)
Myocardial infarction	1.83 (0.99-1.00)	3.15 (0.70-14.18)	12.82 (2.69-60.94)

OR calculated by logistic regression analysis; regression coefficients, corresponding standard errors, and P values for single factors and interactions, significantly associated with gallstones.

Table 5 Predictors of GD in patients with abdominal pain

Variables	Gallstones			Cholecystectomized
	P	OR	95% CI	P	OR	95% CI
Male
Age	0.04	1.033	1.00-1.06	0.02	1.05	1.00-1.10
Pain in the right hypochondrium	0.03	2.35	1.04-5.3	0.62
Pain in the epigastrium	0.68	1.19		0.66
Female
Age	0.000	1.053	1.02-1.08	0.50
Pain in the right hypochondrium	0.36			0.01	14.64	1.83-116.81
Pain in the epigastrium	0.09			0.002	24.19	3.18-183.92

Table 6 Predictors of GD according to the presence of concomitant diseases

Variables	Gallstones			Cholecystectomized
	P	OR	95% CI	P	OR	95% CI
Male
Age	0.0000	1.03	1.02-1.05	0.385
Diabetes	0.0008	2.09	1.36-3.22	0.055
Peptic ulce	0.04	1.44	1.01-2.05	0.004	3.28	1.45-7.41
Cirrhosis	0.002	1.79	1.08-2.97	0.000	5.73	2.13-15.42
Female
Age	0.0000	1.03	1.01-1.04	0.409
Diabetes	0.522			0.208
Peptic ulcer	0.186			0.004	3.19	1.43-7.08
Cirrhosis	0.388			0.742

Table 7 Distribution of symptoms (and unadjusted ORs) in gallstone-free subjects, patients with gallstones not previously diagnosed, patients with a previous diagnosis of gallstones, and patients with a history of cholecystectomy for gallstones

Symptoms (%) OR (95% CI)	Gallstone-free subjects (n = 9001)	Gallstones not previously diagnosed (n = 312)	Gallstones previously diagnosed (n = 112)	Cholecystectomized (n = 61)
Belching	19.1	19.5	27.2	23.1
		1.03 (0.75-1.39)	1.27 (0.86-1.89)	0.92 (0.48-1.75)
Heartburn	32.2	33.1	37.5	44.2
		1.12 (0.85-1.39)	0.89 (0.61-1.30)	1.29 (0.72-2.03)
Nausea	12.3	14.3	18.4	26.9
		1.22 (0.82-1.82)	1.48 (0.90-2.42)	2.40 (1.19-4.83)
Vomiting	7.2	7.7	9.6	9.6
		0.99 (0.59-1.64)	0.79 (0.41-1.53)	0.97 (0.40-2.33)
Bloated feeling after meals	37.2	38.6	44.9	48.1
		1.24 (0.95-1.61)	1.12 (0.78-1.63)	1.24 (0.69-2.21)
Epigastric discomfort	33.8	33.1	40.4	38.5
		0.96 (0.72-1.26)	1.26 (0.87-1.83)	0.87 (0.48-1.59)
Bitter taste in the morning	36.4	35.4	41.2	44.2
		0.93 (0.71-1.21)	0.88 (0.61-1.26)	1.08 (0.61-1.88)
Heavy feeling on the right side	19.7	18.8	25.7	28.8
		0.94 (0.68-1.29)	1.14 (0.77-1.71)	1.09 (0.58-2.05)
Heavy feeling in the epigastrium	22.7	21.3	25.0	26.9
		0.83 (0.60-1.15)	0.81 (0.53-1.24)	0.67 (0.34-1.33)
Pain in the epigastrium	11.2	24.7	39.0	51.2
		1.5 (1.17-2.4)	3.0 (2.6-5.7)	29.9 (7.0-221.3)
Pain in the right hipocondrium	15.8	23.7	39.0	46.5
		1.7 (1.3-2.8)	3.9 (3.1-7.4)	32.1 (9.3-238.9)
Intolerance to fatty or fried foods	24.0	5	4.4	3.4
		0.99 (0.63-1.55)	0.94 (0.19-1.79)	1.04 (0.5-2.14)

Table 8 Distribution of pain characteristics (and unadjusted ORs) in subjects reporting abdominal pain

Characteristics of Pain	Gallstone-free subjects	Gallstones not previously diagnosed (n = 312)	Gallstones previously diagnosed (n = 112)	Cholecystectomized (n = 61)
Radiation
Not radiated (%)	53.0	55.4	43.9	53.5
Radiated (%)	37.4	41.5	45.6	46.5
OR (95% CI)		0.97 (0.63-1.50)	1.11 (0.74-1.66)	0.94 (0.57-1.53)
Duration1
< ½ h (%)	30.3	35.5	7.8	16.3
½-1 h (%)	21.1	19.4	21.6	16.3
1-3 h (%)	16.0	19.4	31.4	18.6
> 3 h (%)	32.6	25.8	39.2	48.8
OR (95% CI)		0.89 (0.71-1.10)	1.35 (1.05-1.75)	1.27 (0.96-1.69)
Tollerability
Not forced to rest (%)	80.5	68.3	62.0	25.6
Forced to rest (%)	19.5	31.7	38.0	74.4
OR (95% CI)		1.98 (1.11-3.51)	2.26 (1.22-4.18)	9.88 (4.82-20.27)
Relationship with meals
Yes (%)	13.2	9.7	10.2	9.5
No (%)	86.8	90.3	89.8	90.5
OR (95% CI)		1.84 (0.64-5.23)	1.30 (0.47-3.63)	1.29 (0.37-4.47)
During meals
Yes (%)	2.6	1.7	6.1
No (%)	97.4	98.3	93.9	100
OR (95% CI)		0.94 (0.12-7.32)	0.38 (0.10-1.48)	129.09 (0.90-4.62)
Soon after meals
Yes (%)	32.3	24.6	43.1	40.5
No (%)	67.7	75.4	56.9	59.5
OR (95% CI)		1.61 (0.84-3.09)	0.70 (0.37-1.31)	0.63 (0.31-1.25)
After heavy meals
Yes (%)	24.5	23.8	26.0	23.8
No (%)	75.5	76.2	74.0	76.2
OR (95% CI)		1.02 (0.55-1.91)	0.73 (0.38-1.38)	1.82 (0.77-4.33)
Relieved by bowel movements
Yes (%)	41	30	28	12.2
No (%)	59	70	72	87.8
OR (95% CI)		2.02 (1.07-3.82)	1.76 (0.99-3.10)	5.35 (2.07-13.76)
Clinical signs of gallstone complications
Yes (%)	29.9	36.4	47.7	69.4
No (%)	70.1	63.6	52.3	30.7
OR (95% CI)		1.31 (0.69-2.46)	2.13 (1.16-3.94)	5.28 (2.56-10.9)

¹The category “< ½ h” has been taken as baseline.