Gallbladder stone incidence and prevalence in Germany: a population-based study

Abstract

Background We aimed to determine the prevalence and incidence of gallbladder stones in a random population-based collective in Germany.

Methods We determined the prevalence and incidence rates of gallbladder stones in a random population sample of 1909 individuals from the Echinococcus-multilocularis in Leutkirch (EMIL) study in 2002 and 380 individuals in a follow-up analysis in the year 2013. The sonographic analysis was performed with a Philipps HDI 5000 (2002) and IU 22 (2013) (Netherlands) transducer 1–5 MHz. Statistical analysis was performed using SAS Version 9.4.

Results The prevalence of gallbladder stones was 3.8 % (69/1909) in 2002 and 10.8 % (41/380) in 2013. In 2013, the gallbladder stone prevalence was 15.1 % (26/172) in women, compared to 7.2 % (15/208) in men. No gallbladder stones were found in participants in the 18–30 or 31–40 age groups. The average annual incidence was 1.03 % in the 41–50 age group, 0.79 % in the 51–65 age group, and 0.63 % in the > 65 age group. The annual incidence was higher among women (1.04 %) than men (0.53 %). The age-associated annual incidence rates for women and men were 1.93 % and 0.5 % in the 41–50 age group, 0.8 % and 0.78 % in the 51–65 age group, and 1.06 % and 0.30 % in the > 65 age group.

Conclusion For the investigated German collective from 2002 to 2013, the average annual incidence of gallbladder stones was 0.75 %, with a higher incidence rate among women. These results are consistent with data from comparable international studies.

Zusammenfassung

Hintergrund Ziel der Studie war es, die Prävalenz von Gallenblasensteinen an einem bevölkerungsbasierten Kollektiv in Deutschland und zudem die ersten Zahlen zur Inzidenz für ein deutsches Kollektiv zu ermitteln.

Methoden Im Jahr 2013 wurden 380 Personen nach 11 Jahren nachuntersucht, welche aus dem initialen Kollektiv der im Jahr 2002 untersuchten 1909 Personen der Echinococcus-multilocularis in Leutkirch (EMIL) Studie rekrutiert wurden. Die sonografische Untersuchung wurde mit einem Philipps HDI 5000 (2002) und IU 22 (2013), Niederlande, Schallkopf 1–5 MHz durchgeführt. Erhoben wurden anthropometrische Daten, ein standardisierter Fragebogen sowie eine vollständige sonografische Untersuchung des Abdomens.

Ergebnisse Die Prävalenz von Gallenblasensteinen betrug im Jahr 2002 3,8 % (69/1909) und im Jahr 2013 10,8 % (41/380). Im Jahr 2013 betrug die Prävalenz von Gallenblasensteinen bei Frauen 15,1 % (26/172), bei Männern 7,2 % (15/208). Es wurden keine Gallenblasensteine bei Teilnehmern in den Altersgruppen 18–30 Jahre oder 31–40 Jahre gefunden. Die durchschnittliche jährliche Inzidenz betrug 1,03 % in der Altersgruppe der 41–50-jährigen, 0,79 % in der Altersgruppe der 51–65-jährigen und 0,63 % in der Altersgruppe der > 65-Jährigen. Die jährliche Inzidenz war bei Frauen (1,04 %) höher als bei Männern (0,53 %). Die altersassoziierten jährlichen Inzidenzraten für Frauen und Männer betrugen in der Altersgruppe der 41–50-jährigen 1,93 % gegenüber 0,5 %, in der Altersgruppe der 51–65-jährigen 0,8 % gegenüber 0,78 % und in der Altersgruppe der > 65-jährigen 1,06 % gegenüber 0,30 %.

Schlussfolgerung Für das untersuchte deutsche Kollektiv im Zeitraum 2002–2013 betrug die durchschnittliche jährliche Inzidenz von Gallenblasensteinen 0,75 %, mit einer höheren Inzidenzrate bei Frauen. Diese Ergebnisse sind konsistent mit Daten aus vergleichbaren internationalen Studien.

Key words

ultrasonography - prevalence - incidence - gallstone disease - Germany

Schlüsselwörter

Ultraschall - Prävalenz - Inzidenz - Gallensteine - Deutschland

Publication History

Received: 09 November 2020

Accepted: 24 February 2021

Article published online:
16 March 2021

• References

• 1 Gutt C, Schläfer S, Lammert F. The treatment of gallstone disease. Dtsch Arztebl Int 2020; 117: 148-158 DOI: 10.3238/arztebl.2020.0148.
• 2 Gutt C, Jenssen C, Barreiros AP. et al. [Updated S3-Guideline for Prophylaxis, Diagnosis and Treatment of Gallstones. German Society for Digestive and Metabolic Diseases (DGVS) and German Society for Surgery of the Alimentary Tract (DGAV) – AWMF Registry 021/008]. Z Gastroenterol 2018; 56: 912-966 DOI: 10.1055/a-0644-2972.
• 3 Stinton LM, Shaffer EA. Epidemiology of gallbladder disease: cholelithiasis and cancer. Gut Liver 2012; 6: 172-187 DOI: 10.5009/gnl.2012.6.2.172.
• 4 Kratzer W, Mason RA, Kächele V. Prevalence of gallstones in sonographic surveys worldwide. J Clin Ultrasound 1999; 27: 1-7 DOI: 10.1002/(sici)1097-0096(199901)27:1<1::aid-jcu1>3.0.co;2-h.
• 5 Shaffer EA. Epidemiology of gallbladder stone disease. Best Pract Res Clin Gastroenterol 2006; 20: 981-996 DOI: 10.1016/j.bpg.2006.05.004.
• 6 Kratzer W, Kron M, Hay B. et al. [Prevalence of cholecystolithiasis in South Germany--an ultrasound study of 2,498 persons of a rural population]. Z Gastroenterol 1999; 37: 1157-1162
• 7 Kratzer W, Kächele V, Mason RA. et al. Gallstone prevalence in Germany: the Ulm Gallbladder Stone Study. Dig Dis Sci 1998; 43: 1285-1291 DOI: 10.1023/A:1018816109905.
• 8 Völzke H, Baumeister SE, Alte D. et al. Independent risk factors for gallstone formation in a region with high cholelithiasis prevalence. Digestion 2005; 71: 97-105 DOI: 10.1159/000084525.
• 9 Nürnberg D, Berndt H, Pannwitz H. [Familial incidence of gallstones]. Dtsch Med Wochenschr 1989; 114: 1059-1063 DOI: 10.1055/s-2008-1066716.
• 10 Berndt H, Nürnberg D, Pannwitz H. Prävalenz der Cholelithiasis. [Prevalence of cholelithiasis. Results of an epidemiologic study using sonography in East Germany]. Z Gastroenterol 1989; 27: 662-666
• 11 Shabanzadeh DM, Sørensen LT, Jørgensen T. Determinants for gallstone formation—a new data cohort study and a systematic review with meta-analysis. Scand J Gastroenterol 2016; 51: 1239-1248 DOI: 10.1080/00365521.2016.1182583.
• 12 Shabanzadeh DM. Incidence of gallstone disease and complications. Curr Opin Gastroenterol 2018; 34: 81-89 DOI: 10.1097/MOG.0000000000000418.
• 13 Chen J-Y, Hsu C-T, Liu J-H. et al. Clinical predictors of incident gallstone disease in a Chinese population in Taipei, Taiwan. BMC Gastroenterol 2014; 14: 83 DOI: 10.1186/1471-230X-14-83.
• 14 Halldestam I, Kullman E, Borch K. Incidence of and potential risk factors for gallstone disease in a general population sample. Br J Surg 2009; 96: 1315-1322 DOI: 10.1002/bjs.6687.
• 15 Festi D, Dormi A, Capodicasa S. et al. Incidence of gallstone disease in Italy. Results from a multicenter, population-based Italian study (the MICOL project). WJG 2008; 14: 5282 DOI: 10.3748/wjg.14.5282.
• 16 Angelico F, Del Ben M, Barbato A. et al. Ten-year incidence and natural history of gallstone disease in a rural population of women in central Italy. The Rome Group for the Epidemiology and Prevention of Cholelithiasis (GREPCO). Ital J Gastroenterol Hepatol 1997; 29: 249-254
• 17 Misciagna G, Leoci C, Guerra V. et al. Epidemiology of cholelithiasis in southern Italy. Part II. Eur J Gastroenterol Hepatol 1996; 8: 585-594 DOI: 10.1097/00042737-199606000-00017.
• 18 Jensen KH, Jørgensen T. Incidence of gallstones in a Danish population. Gastroenterology 1991; 100: 790-794 DOI: 10.1016/0016-5085(91)80027-7.
• 19 Haenle MM, Brockmann SO, Kron M. et al. Overweight, physical activity, tobacco and alcohol consumption in a cross-sectional random sample of German adults. BMC Public Health 2006; 6: 233 DOI: 10.1186/1471-2458-6-233.
• 20 World Health Organization. WHO Expert Committee on Physical Status the Use and Interpretation of Anthropometry: report of a WHO expert committee (WHO technical report series) Genf: World Health Organization. 1995
• 21 Walcher T, Haenle MM, Kron M. et al. Vitamin C supplement use may protect against gallstones: an observational study on a randomly selected population. BMC Gastroenterol 2009; 9: 74 DOI: 10.1186/1471-230X-9-74.
• 22 Wirth J, Joshi AD, Song M. et al. A healthy lifestyle pattern and the risk of symptomatic gallstone disease: results from 2 prospective cohort studies. Am J Clin Nutr 2020; 112: 586-594 DOI: 10.1093/ajcn/nqaa154.
• 23 Kim HS, Cho SK, Kim CS. et al. Big data and analysis of risk factors for gallbladder disease in the young generation of Korea. PLoS One 2019; 14: e0211480 DOI: 10.1371/journal.pone.0211480.