Sociological Risk Factors in the Development of Gallstones for Women in the Childbearing Age a Case-control study

Abstract

Background: Gallstones are highly prevalent in most countries all over the world. Although most of gallstones are asymptomatic, complicated stones lead to important morbidity and complications, and to high costs of medical care, making gallstone prevention highly desirable. The exact etiology of gallstones formation is still unknown, but there are many risk factors that have been proved scientifically to be important contributors for gallstones occurrence. Most of these risk factors are highly related to the ways of human living in modern ages such as unhealthy dietary behaviors and sedentary life. This suggests that sociological backgrounds play a crucial role in the initiation of this disease and the keys for the prevention of gallstones may be through the context of human life. Aim & Objective: To examine sociological risk factors in the development of asymptomatic gallstones of women at childbearing ages attending X-ray department for doing abdominal ultrasound examination for other reason. Study design: Case-control study, where 110 women with asymptomatic gallstones for the first time diagnosed by ultrasound examination without previous episodes of acidity and right hypochondrial pain were allocated as cases. Another 110 women proved to be without gallstones by ultrasound examination and without previous history of acidity or right hypochondrial pain episodes. Matching is done for age ± 5 years. Unpaired sampling technique had been used. Study period: from 1st. October 2006 to 1st. February 2007.Questionnaire: The questionnaire included assessment of sociological factors such as personal characteristics (social identity, personal habits and psychological make-up), life events (stress, social discontinuities and geographical mobility) and social context (economic factors, social integration, urbanization). In addition, body mass index, waist to hip ratio was also estimated and the state of parity for each woman participated in this research. Results: Regarding Personal Characteristics; positive family history was found in this study to be highly associated with the development of gallstones (OR= 2.63, P-value= 0.004, 95%C.I.= 1.73-5.06), as well as sedentary life (OR= 3.97, P-value=0.0001and 95%C.I.= 1.99-7.91), unhealthy dietary behaviors (OR= 3.27, 0.0001, 95%C.I.= 1.89-5.67) and active smoking (OR= 3.32, P-value=0.019 and 95%C.I.= 1.22-9.05). According to Life Events; exposure to stress was found to be associated with the occurrence of gallstones (OR=3.00, p-value= 0.0001, 95%C.I. = 1.70-5.29), and social discontinuities (OR=2.62, p-value= 0.002, 95%C.I. = 1.43-4.79). Central obesity was also found to be associated with the development of gallstones (OR=2.18, P-value=0.004, 95% C.I. =1.27-3.73) as well as high parity (OR=3.47, P-value=0.0001, 95% C.I. = 2.01-6.00). Conclusion: Positive family history, sedentary life, unhealthy dietary behavior, active smoking, stress, social discontinuities, abdominal obesity, and high parity all are among the important sociological risk factors in the development of gallstones for women in childbearing ages.Key words: Sociological risk factors, gallstones, women, childbearing ages.