A Study of the Dietary Factors in the Formation of Biliary Stones: Analysis according to the Location and Composition of the Stones

Min, Young Il; Lee, Sung Koo; Kim, Myung Hwan; Nam, Seung Woo; Seo, Dong Wan; Kim, Yeon Suk; Myung, Seung Jae; Park, Hye Soon

Abstract

BACKGROUND/AIMS: The relative frequency of biliary stones among Korean has been changed recently according to the improvement of socioeconomic status in Korea. Associatecl factors for biliary stone has not been yet evaluated in our country. We performed this study to investigate related risk factors and nutritional factors for biliary stones according to the types of stone.
METHODS
We examined dietary intakes and other risk factors in 107 patients with biliary stones [gallbladder cholesterol stone(GBCS); 38, gallbladder black stone(GBBS); 40, intrahe.patic brown stone(IHBS); 29] who underwent cholecystectomy and/or choledochoscopic stone removal at AMC and 109 control subjects who had no biliary stones confirmed by ultrasonography. We carried out nutritional survey among study subjects by semi-quantitative food frequency method that was usually used in epidemiologic study. The daily intake of major nutrients(energy, carbohydrate, proteins, fats, cholesterol, calcium, iron, alcohol) has been estirnated in those study subjects. The statistical significance of difference was analyzed by SAS 6.10.
RESULTS
In univariate analysis, lower educational level was more frequent in GBBS and IHBS group compared to control. Lower economic status was more frequent in IHBS, white color worker was less frequent in IHBS, and alcohol drinker was less frequent in IHBS group compared to control. Fat intake was lower in GBBS and IHBS group, and cho]esterol intake was significantly higher in GBCS and GBBS group compared to control. In multivariate analysis, higher educational level was noticed to protective factor in GBBS and IHBS. Alcohol and high fat diet were also noticed to protective factors in IHBS. High cholesterol diet was noticed to risk factor in GBCS, GBBS, and IHBS.
CONCLUSIONS
There were some differences in risk factors among biliary stones, according to the location and composition of the stones. Higher cholesterol intake was associated with GBCS, higher cholesterol intake and lower educational level were associated with GBBS, and higher cholesterol intake, lower fat intake, lower alcohol intake, and lower educational level were associated with IHE3S.