Gallstone Prevalence and Risk Factors for Gallstone Disease in an Urban Population of Children and Adolescents

Zusammenfassung

Hintergrund: Derzeit existieren nur wenige sonografische Untersuchungen zur Gallenblasensteinprävalenz und Risikofaktoren bei Kindern und Jugendlichen aus zufälligen repräsentativen Bevölkerungsstichproben. Ziel der Studie war es, dies an einer repräsentativen Bevölkerungsstichprobe zu untersuchen. Methode: Aus einer zufälligen Bevölkerungsstichprobe wurden 307 Kinder und Jugendliche (157 Mädchen, 150 Jungen; Alter 12 – 18 Jahre, mittleres Alter 15,1 ± 2 Jahre), prospektiv sonografisch, mittels standardisiertem Fragebogen und einer Blutentnahme untersucht. Ergebnisse: Bei 3 Jugendlichen (1 Mädchen, 2 Jungen), entsprechend einer Prävalenz von 1 %, wurden Gallenblasensteine nachgewiesen. Unter Anwendung der Cole-Klassifikation waren ein 14-jähriges Mädchen und ein 17-jähriger Junge übergewichtig. Eine positive Familienanamnese und weibliches Geschlecht konnten als Risikofaktoren nicht bestätigt werden. Schlussfolgerung: Adipositas scheint ein Risikofaktor für die Gallenblasensteinbildung auch im Kindes- und Jugendalter zu sein.

Abstract

Background: At present only a few sonography-based studies have assessed gallstone prevalence and associated risk factors in children and adolescents in randomly selected urban population samples. The aim of the present study was to analyze the prevalence of cholecystolithiasis and associated risk factors in children and adolescents. Methods: From a randomly selected urban population sample a total of 307 children and adolescents (157 girls, 150 boys; age 12 – 18 years, mean age 15.1 ± 2.0 years) were studied using ultrasonography, standardized questionnaires and blood samples. Results: Three adolescents (one girl, two boys), corresponding to a prevalence of 1.0 %, showed gallstones. One 14-year-old girl and one 17-year-old boy were overweight using Cole’s classification. A positive family history and female gender could not be confirmed as risk factors. Conclusion: Obesity appears to be a risk factor in the development of gallstones in childhood and adolescence.

Schlüsselwörter

Gallenblasensteinkrankheit - Adipositas - Ultraschall - Prävalenz - Risikofaktor - Kinder

Key words

gallstone disease - obesity - ultrasonography - prevalence - risk factors - children

References

• 1 Batrum R J, Crow H C, Foote S R. Ultrasonic and radiographic cholecystography.  N Engl J Med. 1977;  296 538-541
• 2 Greenberg M, Kangarloo H, Cochran S T. et al . The ultrasonographic diagnosis of cholecystitis and cholelithiasis in children.  Radiology. 1980;  137 745-749
• 3 Kumar R, Nguyen K, Shun A. Gallstones and common bile duct calculi in infancy and childhood.  Aust N Z J Surg. 2000;  70 188-191
• 4 Palasciano G, Portincasa P, Vinciguerra V. et al . Gallstone prevalence and gallbladder volume in children and adolescents: an epidemiological ultrasonographic survey and relationship to body mass index.  Am J Gastroenterol. 1989;  84 1378-1382
• 5 Kächele V, Wabitsch M, Hay B. et al . Cholezystolithiasis bei Kindern und Jugendlichen.  Monatsschr Kinderheilkd. 2000;  148 600-604
• 6 Ttygstad O. Cholelithiasis in children.  Tidsskr Nor Laegeforen. 1958;  78 180-183
• 7 Georgiadis G, Nassis G P. Prevalence of overweight and obesity in a national representative sample of Greek children and adolescents.  Eur J Clin Nutr. 2007;  61 1072-1074
• 8 Malina R M, Reyes M E, Tan S K. et al . Overweight and obesity in a rural Amerindian population in Oaxaca, Southern Mexico, 1968 – 2000.  Am J Hum Biol. 2007;  19 711-721
• 9 Liu J M, Ye R, Li S. et al . Prevalence of overweight/obesity in Chinese children.  Arch Med Res. 2007;  38 882-886
• 10 Lobstein T, Baur L, Uauy R. et al . Obesity in children and young people: a crisis in public health.  Obes Rev. 2004;  5 (Suppl 1) 4-104
• 11 Kaechele V, Wabitsch M, Thiere D. et al . Prevalence of gallbladder stones disease in obese children and adolescents: influence of the degree of obesity, sex, and pubertal development.  J Pediatr Gastroenterol Nutr. 2006;  42 62-66
• 12 Herzog D, Bouchard G. High rate of complicated idiopathic gallstone disease in pediatric patients of a North American tertiary care center.  World J Gastroenterol. 2008;  14 1544-1548
• 13 Landau D A, Goldberg A, Levi Z. et al . The prevalence of gastrointestinal diseases in Israeli adolescents and its association with body mass index, gender, and Jewish ethnicity.  J Clin Gastroenterol. 2008;  42 903-909
• 14 Kang J Y, Ellis C, Majeed A. et al . Gallstones – an increasing problem: a study of hospital admissions in England between 1989 / 1990 and 1999 / 2000.  Aliment Pharmacol Ther. 2003;  17 561-569
• 15 Miltenburg D M, Schaffer 3rd  R, Breslin T. et al . Changing indications for pediatric cholecystectomy.  Pediatrics. 2000;  105 1250-1253
• 16 Haenle M M, Brockmann S O, 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
• 17 The World Medical Association (WMA) .The WMA declaration of Helsinki 1960 with recommendations on biomedical research on human subjects (modified in 1975, 1980 and 1989). 
• 18 WHO Expert Committee on Physical Status .The use and interpretation of anthropometry: report of a WHO expert committee (WHO technical report series). Genf; Health Organization 1995: 427-437
• 19 Cole T J, Bellizzi M C, Flegal K M. et al . Establishing a standard definition for child overweight and obesity worldwide: international survey.  BMJ. 2000;  320 1240-1246
• 20 Wendtland-Born A, Wiewrodt B, Bender S W. et al . Prevalence of gallstones in the neonatal period.  Ultraschall in Med. 1997;  18 80-83
• 21 Wesdorp I, Bosman D, Graaff de A. et al . Clinical presentations and predisposing factors of cholelithiasis and sludge in children.  J Pediatr Gastroenterol Nutr. 2000;  31 411-417
• 22 Gumiero A P, Bellomo-Brandão M A, da Costa-Pinto E A. Gallstones in children with sickle cell disease followed up at a Brazilian hematology center.  Arq Gastroenterol. 2008;  45 313-318
• 23 Acun C, Erdem L O, Sögüt A. et al . Gallbladder and urinary tract precipitations associated with ceftriaxone therapy in children: a prospective study.  Ann Trop Paediatr. 2004;  24 25-31
• 24 Danon Y L, Dinari G, Garty B Z. et al . Cholelithiasis in children with immunoglobulin. A deficiency: a new gastroenterologic syndrome.  J Pediatr Gastroenterol Nutr. 1983;  2 663-666
• 25 De Santis A, Paganelli R, Stefanoni R. et al . Prevalence of gallstones in patients with primary immunoglobulin deficiency. Evidence for lack of association.  Dig Dis Sci. 1990;  35 716-720
• 26 Callahan J, Haller J O, Cacciarelli A A. et al . Cholelithiasis in infants: association with total parenteral nutrition and furosemide.  Radiology. 1982;  143 437-439
• 27 Marschall H U, Einarsson C. Gallstone disease.  J Intern Med. 2007;  261 529-542
• 28 Kratzer W, Mason R A, Kachele V. Prevalence of gallstones in sonographic surveys worldwide.  J Clin Ultrasound. 1999;  27 1-7
• 29 Honore L H. Cholesterol cholelithiasis in adolescent females: its connection with obestiy, parity, and oral contraceptive use – a retrospective study of 31 cases.  Arch Surg. 1980;  115 62-64
• 30 Reif S, Sloven D G, Lebenthal E. Gallstones in children. Characterization by age, etiology, and outcome.  Am J Dis Child. 1991;  145 105-108
• 31 Von Bergmann K, Becker M, Leiss O. Biliary cholesterol saturation in non-obesewomen and non-obese men before and after puberty.  Eur J Clin Invest. 1986;  16 531-535