Prevalence and ethnic differences in gallbladder disease in the United States

doi:10.1016/S0016-5085(99)70456-7

Gastroenterology

Volume 117, Issue 3, September 1999, Pages 632-639

https://doi.org/10.1016/S0016-5085(99)70456-7 Get rights and content

Abstract

Background & Aims: Gallbladder disease is one of the most common conditions in the United States, but its true prevalence is unknown. A national population-based survey was performed to determine the age, sex, and ethnic distribution of gallbladder disease in the United States. Methods: The third National Health and Nutrition Examination Survey (NHANES III) conducted gallbladder ultrasonography among a representative U.S. sample of more than 14,000 persons. The diagnosis of gallbladder disease by detection of gallstones or cholecystectomy was made with excellent reproducibility. Results: An estimated 6.3 million men and 14.2 million women aged 20–74 years had gallbladder disease. Age-standardized prevalence was similar for non-Hispanic white (8.6%) and Mexican American (8.9%) men, and both were higher than non-Hispanic black men (5.3%). These relationships persisted with multivariate adjustment. Among women, age-adjusted prevalence was highest for Mexican Americans (26.7%) followed by non-Hispanic whites (16.6%) and non-Hispanic blacks (13.9%). Among women, multivariate adjustment reduced the risk of gallbladder disease for both Mexican Americans and non-Hispanic blacks compared with non-Hispanic whites. Conclusions: More than 20 million persons have gallbladder disease in the United States. Ethnic differences in gallbladder disease prevalence differed according to sex and were only partly explained by known risk factors.

GASTROENTEROLOGY 1999;117:632-639

Section snippets

Study participants

NHANES III was conducted by the National Center for Health Statistics of the Centers for Disease Control and Prevention (CDC) from September 1988 through September 1994. Designed to provide national estimates of health and nutritional status of the civilian noninstitutionalized population of the United States, NHANES III gathered information through household interviews, standardized physical examinations, and laboratory testing. The study was approved by the CDC Institutional Review Board, and

Results

Diagnostic gallbladder ultrasonography examinations were performed on 14,238 NHANES III participants, of whom 1149 had gallstones and 886 had undergone cholecystectomies. A total of 20.5 million persons in the United States, 6.3 million men and 14.2 million women, aged 20–74 years were estimated to have GBD (Table 1).

. Prevalence and 95% CI of gallstones, cholecystectomies, and GBD by sex and age group in the United States in 1988–1994

Empty Cell	Empty Cell	Gallstones		Cholecystectomy		GBD
Sex, age group (yr)	Sample size	Empty Cell

Discussion

The NHANES III applied ultrasonography of the gallbladder to a large multiethnic population sample with the goal of establishing the prevalence and risk factors for GBD in the United States. Data collection and quality control were carefully considered from the outset with 2 independent assessments of every ultrasound and repeat ultrasound examination for more than 1100 participants. The chance corrected percent agreement for gallstones and cholecystectomy between readers and between repeat

Acknowledgements

The authors thank the following persons for their assistance in planning and executing the NHANES III ultrasound examinations: ultrasonographers Cynthia Runco and Diane Palmer; radiologists Diane Huntington, Thomas Shawker, Roger Sanders, and Cecilia Brennicke; and Pierre Renault, Harold Roth, and Catherine Novak.

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^☆: Address requests for reprints to: James E. Everhart, Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, Natcher Building, Room 6AN-12J, 45 Center Drive, MSC 6600, Bethesda, Maryland 20892-6600. e-mail: [email protected].

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Liver, Pancreas, and Biliary TractPrevalence and ethnic differences in gallbladder disease in the United States☆

Abstract

Section snippets

Study participants

Results

Discussion

Acknowledgements

Gastroenterology

Gastroenterology

J Chronic Dis

Lancet

Med Hypotheses

Am J Clin Nutr

Am J Clin Nutr

Lancet

Gallstones

Gallstones

Plan and operation of the Third National Health and Nutrition Examination Survey, 1988–1994

SUDAAN User's Manual, Release 6.0

Statistical methods in cancer research: the design and analysis of cohort studies

Prevalence of clinical gallbladder disease in Mexican-American, Anglo, and black women

South Med J

Individual admixture estimates: disease associations and individual risk of diabetes and gallbladder disease among Mexican-Americans in Starr County, Texas

Am J Phys Anthropol

Genetics and epidemiology of gallbladder disease in new world native peoples

Am J Hum Genet

A comparison of three methods for assessing Amerindian admixture in Mexican Americans

Ethn Dis

Genetic admixture and gallbladder disease in Mexican Americans

Am J Phys Anthropol

Low incidence of hospitalization with gallbladder disease among blacks in the United States

Am J Epidemiol

Liver, Pancreas, and Biliary Tract
Prevalence and ethnic differences in gallbladder disease in the United States☆