Predictors of cholesterol gallstone formation among inhabitants of Port Harcourt in Nigeria

Promise N. Wichendu, Collins Amadi


Background: Various clinical and biochemical parameters have been hypothesized to predict cholesterol gallstone formation. Hence, this study was structured to evaluate the degree of some of these suggested predictors among inhabitants of Port Harcourt in Nigeria.

Methods: This was a retrospective study of the clinical and biochemical parameters of 42 cholesterol gallstones formers within a tertiary hospital in Nigeria. Records of age, gender, weight, height, calculated body mass index and plasma biochemical parameters (total cholesterol, total bilirubin, and total calcium) of cholesterol gallstone formers from 1st January 2008 to 31st December 2017 were abstracted from medical and laboratory records and analysed using SPSS version 20.

Results: There were more females (70%) than males (30%) with a ratio of 2.3:1. The age ranged from 31-64 with mean 46.78±9.33. Obesity was observed among 40.5% of study population. Female gender (OR = 2.823; 95% CI = 2.446-3.200; p<0.001), obesity BMI status (OR = 1.534; 95% CI = 1.436 - 1.632; p = 0.012) and abnormal plasma cholesterol status (OR = 3.011; 95% CI = 2.916 - 3.106; p<0.001) were significant predictors of cholesterol gallstone formation. Abnormal plasma cholesterol status was the strongest of the predictors with AUC of 0.920 (p<0.001), seconded by female gender (AUC = 0.889; p<0.001) and obesity BMI status (AUC = 0.834; p<0.001).

Conclusions: Abnormal plasma cholesterol status is the strongest independent predictor of cholesterol gallstone formation, seconded by female gender and high BMI status, among inhabitants of Port Harcourt in Nigeria.


BMI, ETV, Cholesterol gallstone, Female gender, Plasma cholesterol

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Everhart JE, Khare M, Hill M, Maurer KR. Prevalence and ethnic differences in gallbladder disease in the United States. Gastroenterol. 1999 Sep 30;117(3):632-9.

Völzke H, Baumeister SE, Alte D, Hoffmann W, Schwahn C, Simon P, et al. Independent risk factors for gallstone formation in a region with high cholelithiasis prevalence. Digestion. 2005;71(2):97-105.

Shaffer EA. Epidemiology and risk factors for gallstone disease: has the paradigm changed in the 21st century?. Current Gastroenterol Reports. 2005 Apr 1;7(2):132-40.

Conte D, Fraquelli M, Giunta M, Conti CB. Gallstones and liver disease: an overview. J Gastrointestin Liver Dis. 2011 Mar 1;20(1):9-11.

Van Erpecum KJ. Pathogenesis of cholesterol and pigment gallstones: an update. Clin Res Hepatol Gastroenterol. 2011 Apr 1;35(4):281-7.

Amadi C, Wichendu PN. Biochemical constituents of gallstones from indigenous blacks of Nigerian origin. Int J Scientific Reports. 2018 Apr 25;4(5):104-8.

Paumgartner G, Sauerbruch T. Gallstone: Pathogenesis. Lancet. 1991;338;1117-21.

Amigo L, Zanlungo S, Mendoza H, Miquel JF, Nervi F. Risk factors and pathogenesis of cholesterol gallstones: state of the art. Eur Review Med Pharmacological Sci. 1999;3:241-6.

Carey MC. Pathogenesis of gallstones. Recenti Prog Med. 1992;83(7-8):379-9.

Reshetnyak VI. Concept of the pathogenesis and treatment of cholelithiasis. World J Hepatol. 2012 Feb 27;4(2):18.

World Health Organization. Physical Status: The Use and Interpretation of Anthropometry. Geneva, Switzerland: World Health Organization. Technical Report Series. 1995:854.

Expert Panel on Detection E. Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA. 2001 May 16;285(19):2486-97.

Atamanalp SS, Keles MS, Atamanalp RS, Acemoglu H, Laloglu E. The effects of serum cholesterol, LDL, and HDL levels on gallstone cholesterol concentration. Pak J Med Sci. 2013 Jan;29(1):187-90.

Khairy G, Guraya SY, Murshid KR. Incidence, correlation with serum cholesterol I and the role of laparoscopic cholecystectom. Saudi Med J. 2004;25(9):1226-8.

Halldestam I, Kullman E, Borch K. Incidence of and potential risk factors for gallstone disease in a general population sample. Br J Surg: Incorporating Eur J Surgery Swiss Surgery. 2009 Nov;96(11):1315-22.

Thijs C, Knipschild P, Brombacher P. Serum lipids and gallstones: a case-control study. Gastroenterol. 1990 Sep 1;99(3):843-9.

Asuquo ME, Umoh MS, Nwagbara V, Inyang A, Agbor C. Cholecystectomy: Indications at university of Calabar teaching hospital, Calabar, Nigeria. Annals of African medicine. 2008 Mar 1;7(1):35-7.

Reshetnk VI. Concept of the pathogenesis and treatment of cholelithiasis. World J Hepatol. 2012 Feb 27;4(2):18-34.

Novacek G. Gender and gallstone disease. Viennese medical weekly. 2006 Oct 1;156(19-20):527-33.

Stinton LM, Shaffer EA. Epidemiology of gallbladder disease: cholelithiasis and cancer. Gut Liver. 2012 Apr;6(2):172.

Erlinger S. Gallstones in obesity and Weight loss. Eur J Gastroenterol Hepatol. 200;12(12):1347-52.

Grundy SM. Cholesterol gallstones: a fellow traveler with metabolic syndrome?. Am J Clin Nutr. 2000;80:1-2.

Tirziu SI, Bel SI, Bondor CI, Acalovschi MO. Risk factors for gallstone disease in patients with gallstones having gallstone heredity. A case-control study. Rom J Intern Med. 2008 Feb;46(3):223-8.

Liu T, Wang W, Ji Y, Wang Y, Liu X, Cao L, et al. Association between different combination of measures for obesity and new-onset gallstone disease. PLoS One. 2018 May 17;13(5):e0196457..

Mabee TM, Meyer P, Denbesten L, Mason EE. The mechanism of gallstone increased gallstone formation in obese human subjects. Surgery. 1976;79(4): 460-8.