Kaiser Permanente study finds obese youth have significantly higher risk of gallstones

Children who are overweight or obese face an increased risk for gallstones, according to a Kaiser Permanente study published in the Journal of Pediatric Gastroenterology & Nutrition.

Researchers found that children and adolescents who were overweight were twice as likely to have gallstone disease, compared to children and adolescents who had a normal body mass index. Those who were moderately obese were four times as likely to have gallstones and those who were extremely obese were six times as likely to have gallstones.

The study was based on information in the electronic health records of more than 510,000 children ages 10 to 19, from 2007 through 2009, who were members of Kaiser Permanente Southern California.

The size and diversity of this population-based study allowed researchers to explore racial and ethnic disparities. Hispanic youth were more likely to have gallstones than youth of other races and ethnicities.

"Although gallstones are relatively common in obese adults, gallstones in children and adolescents have been historically rare," said study lead author Corinna Koebnick, PhD, of the Kaiser Permanente Southern California Department of Research & Evaluation. "These findings add to an alarming trend-youth who are obese or extremely obese are more likely to have diseases we normally think of as adult conditions."

Researchers found a stronger association between obesity and gallstones in girls than in boys. Girls who were obese and extremely obese were six and eight times more likely, respectively, to have gallstones than girls who were underweight or of normal weight, while obese and severely obese boys were more than twice and three times as likely to have gallstones as their normal or underweight counterparts.

Gallstone disease is a major health problem in the United States, affecting an estimated 20 million adults. Symptoms of gallstones include recurrent abdominal pain and nausea, although many people with gallstones have no symptoms. Gallstones can block the passage of bile into the intestine, which in turn can cause severe damage or infection in the gallbladder, liver, or pancreas and, if left untreated, the condition can be fatal.

How Are Gallstones Linked to Obesity? Obese individuals are more likely to develop gallstones than those who are at a healthier weight. For women, obesity is an even stronger risk factor for developing gallstones. Researchers have found that obese individuals tend to produce higher levels of cholesterol than normal. This leads to production of bile that contains more cholesterol than can be dissolved. When this happens, gallstones can form from the undissolved cholesterol. Additionally, in the obese, gallbladders may not empty normally or completely.

Research has shown that those who have excess fat around their stomach (abdominal obesity) may be at a greater risk for developing gallstones than those who carry excess fat mainly around their hip and thigh areas.