Brief Article
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World J Gastroenterol. Apr 14, 2012; 18(14): 1652-1659
Published online Apr 14, 2012. doi: 10.3748/wjg.v18.i14.1652
A population-based cohort study of symptomatic gallstone disease in diabetic patients
Chi-Ming Liu, Chung-Te Hsu, Chung-Yi Li, Chu-Chieh Chen, Meng-Lun Liu, Jorn-Hon Liu
Chi-Ming Liu, Department of Medical Research and Education, Division of General Surgery, Cheng-Hsin General Hospital, Taipei 11220, Taiwan, China
Chi-Ming Liu, Institute of Public Health, Yang-Ming University, Taipei 11220, Taiwan, China
Chung-Te Hsu, Division of Gastroenterology, Cheng-Hsin General Hospital, National Defense Medical Center, Taipei 11220, Taiwan, China
Chung-Yi Li, Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan, China
Chu-Chieh Chen, Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei 11257, Taiwan, China
Meng-Lun Liu, Division of General Surgery, Cheng-Hsin General Hospital, Taipei 11220, Taiwan, China
Jorn-Hon Liu, Dean’s Office, Cheng-Hsin General Hospital, Taipei 11220, Taiwan, China
Jorn-Hon Liu, Department of Medicine, School of Medicine, National Yang-Ming University, Taipei 11220, Taiwan, China
Author contributions: Liu CM and Liu JH conceived and designed the study; Liu CM, Li CY and Chen CC acquired the data; Hsu CT assisted in critical review the manuscript and organize the structure of the manuscript; Liu ML performed the statistical analysis and interpreted the data; Liu CM provided technical support and materials, supervised the study and wrote the manuscript; Liu JH critically revised the manuscript for intellectual content.
Supported by The Cheng-Hsin General Hospital and National Yang-Ming University
Correspondence to: Dr. Chi-Ming Liu, Assistant Professor, Department of Medical Research and Education, Division of General Surgery, Cheng-Hsin General Hospital, No. 45, Cheng Hsin St., Pai-Tou, Taipei 11220, Taiwan, China.
Telephone: +886-2-23896392 Fax: +886-2-23814236
Received: July 29, 2011
Revised: November 8, 2011
Accepted: December 16, 2011
Published online: April 14, 2012

AIM: To investigate the prevalence of gallstone disease (GSD) and to evaluate the risk of symptomatic GSD among diabetic patients.

METHODS: The study was conducted by analyzing the National Health Research Institutes (NHRI) dataset of ambulatory care patients, inpatient claims, and the updated registry of beneficiaries from 2000 to 2008. A total of 615 532 diabetic patients without a prior history of hospital treatment or ambulatory care visits for symptomatic GSD were identified in the year 2000. Age- and gender-matched control individuals free from both GSD and diabetes from 1997 to 1999 were randomly selected from the NHIR database (n = 614 871). The incidence densities of symptomatic GSD were estimated according to the subjects’ diabetic status. The distributions of age, gender, occupation, income, and residential area urbanization were compared between diabetic patients and control subjects using Cox proportion hazards models. Differences between the rates of selected comorbidities were also assessed in the two groups.

RESULTS: Overall, 60 734 diabetic patients and 48 116 control patients developed symptomatic GSD and underwent operations, resulting in cumulative operation rates of 9.87% and 7.83%, respectively. The age and gender distributions of both groups were similar, with a mean age of 60 years and a predominance of females. The diabetic group had a significantly higher prevalence of all comorbidities of interest. A higher incidence of symptomatic GSD was observed in females than in males in both groups. In the control group, females under the age of 64 had a significantly higher incidence of GSD than the corresponding males, but this difference was reduced with increasing age. The cumulative incidences of operations for symptomatic GSD in the diabetic and control groups were 13.06 and 9.52 cases per 1000 person-years, respectively. Diabetic men exhibited a higher incidence of operations for symptomatic GSD than did their counterparts in the control group (12.35 vs 8.75 cases per 1000 person-years).

CONCLUSION: The association of diabetes with increased symptomatic GSD may provide insight to the treatment or management of diabetes in clinical settings.

Keywords: Gallstone disease, Diabetes, Symptomatic, Incidence density, Hazard ratio