Research article

Predictors of gallstone composition in 1025 symptomatic gallstones from Northern Germany

Clemens Schafmayer¹ , Jürgen Hartleb² , Jürgen Tepel¹ , Stefan Albers³ , Sandra Freitag⁴ , Henry Völzke⁵ , Stephan Buch³ , Markus Seeger³ , Birgit Timm⁶ , Bernd Kremer¹ , Ulrich R Fölsch³ , Fred Fändrich¹ , Michael Krawczak^4,6 , Stefan Schreiber^6,7 and Jochen Hampe³

¹Department of General and Thoracic Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 7, D-24105 Kiel, Germany

²Laboratory Arndt and Partner, Lademannbogen 61–63, Hamburg, D-22339 Hamburg, Germany

³Department of General Internal Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Schittenhelmstr. 12, D-24105 Kiel, Germany

⁴Institute of Medical Statistics and Biometry, University Hospital Schleswig-Holstein, Campus Kiel, Brunswiker Str. 10, D-24105 Kiel, Germany

⁵Department of Community Medicine, University of Greifswald, Walter-Rathenau-Str. 48, D-17487 Greifswald, Germany

⁶POPGEN Biobank, University Hospital Schleswig-Holstein, Campus Kiel, Schittenhelmstr. 12, D-24105 Kiel, Germany

⁷Institute of Clinical Molecular Biology, University Hospital Schleswig-Holstein, Campus Kiel, Schittenhelmstr. 12, D-24105 Kiel, Germany

author email corresponding author email

BMC Gastroenterology 2006, 6:36doi:10.1186/1471-230X-6-36

Published:	22 November 2006

Abstract

Background

Gallstones represent a prevalent and costly health problem. The changing epidemiology and the emerging non-surgical interventions for gallstone disease necessitate the definition of target populations for future therapies. This study aimed to define patterns of gallstone composition and identify demographic predictors of gallstone composition in a large sample of symptomatic gallstones from Northern Germany.

Methods

One thousand and seventy-four post-cholecystectomy gallstone specimens were obtained. Demographic and clinical information was provided by questionnaire (N = 1025 independent individuals with complete information). Two samples from each gallstone were analyzed using Fourier transformed infrared spectrometry.

Results

The most prevalent substance was cholesterol, which was detected in 95.0% of gallstone specimens. Bilirubin and bilirubinate were present in 30.0% and calcium was detected in 10.0% of the spectra. Ninety-two percent of measurements from the same stone yielded the same "main" substances, indicating a homogenous stone composition in most cases. Female sex and higher body mass index (BMI) were associated with the presence of cholesterol as a main substance in the gallstones (p < 0.001).

Conclusion

The changing epidemiology of gallstone disease is reflected by a marked shift in stone composition: Only two percent of stones in this study were pigment stones as compared to 91% percent of stones containing cholesterol as a main substance. Obese individuals from Germany with a BMI > 30 kg/m² have in 95% cholesterol-dominant gallstones and represent a potential target population for non-surgical interventions for the prevention or treatment of cholesterol stones.