Research article

Vitamin C supplement use may protect against gallstones: an observational study on a randomly selected population

Thomas Walcher^{* 1} , Mark M Haenle^{* 2} , Martina Kron³ , Birgit Hay³ , Richard A Mason⁴ , Daniel Walcher¹ , Gerald Steinbach⁵ , Peter Kern⁶ , Isolde Piechotowski⁷ , Guido Adler² , Bernhard O Boehm² , Wolfgang Koenig¹ and Wolfgang Kratzer² for the EMIL study group

¹Department of Internal Medicine II, University Hospital Ulm, Ulm, Germany

²Department of Internal Medicine I, University Hospital Ulm, Ulm, Germany

³Department of Biometry and Medical Documentation, Ulm University, Ulm, Germany

⁴Department of Veterans Affairs, Louis Stokes Cleveland Medical Center, Brecksville Division, Brecksville, Ohio 44141, USA

⁵Department of Clinical Chemistry and Pathobiochemistry, University Hospital Ulm, Ulm, Germany

⁶Department of Internal Medicine III, Division of Infectious Diseases and Clinical Immunology, University Hospital Ulm, Ulm, Germany

⁷Baden-Württemberg State Health Office, District Government Stuttgart, Stuttgart, Germany

author email corresponding author email* Contributed equally

BMC Gastroenterology 2009, 9:74doi:10.1186/1471-230X-9-74

Published:	8 October 2009

Abstract

Background

Animal experiments have shown a protective effect of vitamin C on the formation of gallstones. Few data in humans suggest an association between reduced vitamin C intake and increased prevalence of gallstone disease. The aim of this study was to assess the possible association of regular vitamin C supplementation with gallstone prevalence.

Methods

An observational, population-based study of 2129 subjects aged 18-65 years randomly selected from the general population in southern Germany was conducted. Abdominal ultrasound examination, completion of a standardized questionnaire, compilation of anthropometric data and blood tests were used. Data were collected in November and December 2002. Data analysis was conducted between December 2005 and January 2006.

Results

Prevalence of gallstones in the study population was 7.8% (167/2129). Subjects reporting vitamin C supplementation showed a prevalence of 4.7% (11/232), whereas in subjects not reporting regular vitamin C supplementation, the prevalence was 8.2% (156/1897). Female gender, hereditary predisposition, increasing age and body-mass index (BMI) were associated with increased prevalence of gallstones. Logistic regression with backward elimination adjusted for these factors showed reduced gallstone prevalence for vitamin C supplementation (odds ratio, OR 0.34; 95% confidence interval, CI 0.14 to 0.81; P = 0.01), increased physical activity (OR 0.62; 95% CI, 0.42 to 0.94; P = 0.02), and higher total cholesterol (OR 0.65; 95% CI, 0.52 to 0.79; P < 0.001).

Conclusion

Regular vitamin C supplementation and, to a lesser extent, increased physical activity and total cholesterol levels are associated with a reduced prevalence of gallstones. Regular vitamin C supplementation might exert a protective effect on the development of gallstones.