Research Article: Big data and analysis of risk factors for gallbladder disease in the young generation of Korea

Date Published: February 22, 2019

Publisher: Public Library of Science

Author(s): Hyung Sun Kim, Seong Kyung Cho, Chang Soo Kim, Joon Seong Park, David Meyre.


Few studies have examined the risk factors for gallbladder (GB) disease in young adults. This study aimed to evaluate risk factors for GB disease in young adults based on big data in Korea.

All participants underwent routine checkup at the Korea Medical Institute from June 2014 to May 2015. After excluding 677 individuals with missing information in records, 724,114 individuals (435,635 men, 288,479 women) were finally included. The definition of abnormal GB finding included stones, sludge, polyps, and adenomyomatosis detected using ultrasonography. All statistical analyses were performed using SAS software version 9.2.

Overall, 27,130 (17.5%) individuals were diagnosed as having abnormal GB finding in the young age group (N = 154,463, aged 20–39 years). In men, significant differences in low-density lipoprotein (LDL) and cholesterol levels were observed between the abnormal GB finding group and normal GB group (p < 0.05). In women, a significant difference in smoking history was noted between the abnormal GB finding group and normal GB group (p < 0.05). The prevalence rate of GB stones was 1.9% (27,979/154,463) in the young age group. High body mass index (BMI), large thigh circumference, and low high-density lipoprotein (HDL) level in women and low HDL level in men were independent risk factors for the presence of GB stones (p < 0.05). In this study, obesity-related factors (BMI, waist size, thigh circumference, and cholesterol, LDL, and HDL levels) correlated with GB disease in the young generation of Korea.

Partial Text

Gallbladder (GB) disease is a common disease of the digestive system known to occur in approximately 20% of healthy adults. In general, the prevalence of GB disease is more than double in women than in men and increases with age in both sexes, reaching approximately 30% at the age of 70 years [1–8]. In 2015, cholecystectomy ranked seventh among operative cases in Korea that were filed with the Health Insurance Review and Assessment Service [9]. Recent studies have reported a 27% growth in the number of cholecystectomies in 2015 compared with that in 2010 [9]. In Asian countries, the prevalence rate of cholelithiasis ranges from 3% to 10%; specifically, according to recent studies, the prevalence rates of cholelithiasis were 3.2% in Japan [1], 10.7% in China [2], 7.1% in North India [3], and 5.0% in Taiwan [4].

BMI, obesity, abdominal fat, metabolic syndrome, and diabetes mellitus are confirmed risk factors for gallstones [5, 10, 12, 21–24]. However, the prevalence of abnormal GB finding among young adults with a high level of obesity has not been investigated. The present study is the first large-scale study on abnormal GB findings detected by abdominal ultrasonography in healthy individuals. As the prevalence of obesity increases globally [25–27], the prevalence of gallstones associated with obesity is expected to also increase. In particular, the prevalence of obesity is rapidly increasing in Korea owing to the westernization of food and lifestyle [28]. In recent years, obesity has emerged as a major health threat in Korea [29]. The Korean National Health Insurance Service reported that the percentage of obese Koreans (those with a BMI of 30 kg/m2 or above) increased from 2.5% of the entire population in 2002 to 4.2% in 2012 and that the prevalence rate of GB stones in the 20s and 30s was 0.95% and 2.26%, respectively [9]. According to another study, the prevalence rate of gallstones in the early 2000s was 0.39% for those aged <30 years and 0.99% for those in their 30s [21]. In the present study, which was performed using data from September 2014 to August 2015, the prevalence rate of abnormal GB finding and GB stones was 17.5% and 1.9%, respectively. This result showed that the increase in obesity in Korea for approximately 10 years was associated with an increase in the prevalence of gallstones. This study is the first attempt to analyze the prevalence of and risk factors for GB disease in young adults based on large-scale health screening data. The use of big data aims to analyze large, heterogeneous datasets to provide in-depth insights into complex processes, and it has the advantages of evaluating risk factors. Based on these results, we might consider the probability of GB disease in young adults with digestive symptoms, such as persistent abdominal discomfort.   Source:


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