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. 2000 Jul;47(1):144–147. doi: 10.1136/gut.47.1.144

Insulin and gall stones: a population case control study in southern Italy

G Misciagna 1, V Guerra 1, L Di 1, M Correale 1, M Trevisan 1
PMCID: PMC1727980  PMID: 10861277

Abstract

BACKGROUND—Hyperinsulinaemia has been associated with many common diseases in developed countries, such as ischaemic heart disease and colon cancer. Gall stones are also very prevalent in these countries but little is known about the association between insulin and gall stones.
AIMS—To study the relationships between insulin and the incidence of gall stones in a sample of the general population.
SUBJECTS AND METHODS—Between May 1985 and June 1986, systematic sampling from the electoral register of Castellana, a small town in southern Italy, yielded 2472 subjects who had their gall bladder checked for gall stones by ultrasonography. Between May 1992 and June 1993, 1962 of the 2235 subjects without gall stones at the first examination agreed to a further ultrasound examination. A total of 101 subjects with newly diagnosed gall stones and 303 randomly chosen controls entered the study. Serum insulin was determined by radioimmunoassay, and concentrations of cholesterol, cholesterol high density lipoprotein (HDL), glucose, and triglycerides by standard enzymatic colorimetric methods. Unconditional multiple logistic regression was used to study the association between insulin and gall stones, controlling for the most common confounding factors.
RESULTS—In individuals with no clinical diagnosis of diabetes and serum glucose <7 mmol/l, insulin was associated with gall stones. This association persisted even after controlling for sex, age, body mass index, and serum glucose. The risk of gall stones in the highest quintile of serum insulin was 2.66 (95% confidence interval 1.04-6.72; χ2 test for trend, p=0.03). The association of insulin with gall stones persisted when total and HDL cholesterol were entered in the logistic regression models, and only slightly decreased when serum triglycerides were included in the model.
CONCLUSIONS—The results of the study indicate that hyperinsulinaemia may play an important role in the aetiology of gall stones even in individuals without diabetes and with normal serum glucose levels.


Keywords: gallstones; insulin; epidemiology; case control study

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Selected References

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  1. Barbara L., Sama C., Morselli Labate A. M., Taroni F., Rusticali A. G., Festi D., Sapio C., Roda E., Banterle C., Puci A. A population study on the prevalence of gallstone disease: the Sirmione Study. Hepatology. 1987 Sep-Oct;7(5):913–917. doi: 10.1002/hep.1840070520. [DOI] [PubMed] [Google Scholar]
  2. Bennion L. J., Grundy S. M. Effects of diabetes mellitus on cholesterol metabolism in man. N Engl J Med. 1977 Jun 16;296(24):1365–1371. doi: 10.1056/NEJM197706162962401. [DOI] [PubMed] [Google Scholar]
  3. Björntorp P. Abdominal obesity and the metabolic syndrome. Ann Med. 1992 Dec;24(6):465–468. doi: 10.3109/07853899209166997. [DOI] [PubMed] [Google Scholar]
  4. Caroli A., Sardeo G., Gasparoni P., Volpi A., Cecchetto G., Piaserico G. P. Rapporti tra insulina plasmatica e calcolosi biliare nel paziente diabetico. Minerva Dietol Gastroenterol. 1988 Jul-Sep;34(3):205–208. [PubMed] [Google Scholar]
  5. De Santis A., Attili A. F., Ginanni Corradini S., Scafato E., Cantagalli A., De Luca C., Pinto G., Lisi D., Capocaccia L. Gallstones and diabetes: a case-control study in a free-living population sample. Hepatology. 1997 Apr;25(4):787–790. doi: 10.1002/hep.510250401. [DOI] [PubMed] [Google Scholar]
  6. Ferrannini E., Haffner S. M., Mitchell B. D., Stern M. P. Hyperinsulinaemia: the key feature of a cardiovascular and metabolic syndrome. Diabetologia. 1991 Jun;34(6):416–422. doi: 10.1007/BF00403180. [DOI] [PubMed] [Google Scholar]
  7. Festi D., Lalloni L., Taroni F., Barbara L., Menotti A., Ricci G. Inter and intra-observer variation in ultrasonographic detection of gallstones: the Multicenter Italian study on epidemiology of cholelithiasis (M.I.COL.). Eur J Epidemiol. 1989 Mar;5(1):51–57. doi: 10.1007/BF00145045. [DOI] [PubMed] [Google Scholar]
  8. Giovannucci E. Insulin and colon cancer. Cancer Causes Control. 1995 Mar;6(2):164–179. doi: 10.1007/BF00052777. [DOI] [PubMed] [Google Scholar]
  9. Gray R. S., Fabsitz R. R., Cowan L. D., Lee E. T., Howard B. V., Savage P. J. Risk factor clustering in the insulin resistance syndrome. The Strong Heart Study. Am J Epidemiol. 1998 Nov 1;148(9):869–878. doi: 10.1093/oxfordjournals.aje.a009712. [DOI] [PubMed] [Google Scholar]
  10. Haffner S. M., Diehl A. K., Mitchell B. D., Stern M. P., Hazuda H. P. Increased prevalence of clinical gallbladder disease in subjects with non-insulin-dependent diabetes mellitus. Am J Epidemiol. 1990 Aug;132(2):327–335. doi: 10.1093/oxfordjournals.aje.a115662. [DOI] [PubMed] [Google Scholar]
  11. Haffner S. M., Diehl A. K., Stern M. P., Hazuda H. P. Central adiposity and gallbladder disease in Mexican Americans. Am J Epidemiol. 1989 Mar;129(3):587–595. doi: 10.1093/oxfordjournals.aje.a115171. [DOI] [PubMed] [Google Scholar]
  12. Haffner S. M., Diehl A. K., Valdez R., Mitchell B. D., Hazuda H. P., Morales P., Stern M. P. Clinical gallbladder disease in NIDDM subjects. Relationship to duration of diabetes and severity of glycemia. Diabetes Care. 1993 Sep;16(9):1276–1284. doi: 10.2337/diacare.16.9.1276. [DOI] [PubMed] [Google Scholar]
  13. Kono S., Shinchi K., Ikeda N., Yanai F., Imanishi K. Prevalence of gallstone disease in relation to smoking, alcohol use, obesity, and glucose tolerance: a study of self-defense officials in Japan. Am J Epidemiol. 1992 Oct 1;136(7):787–794. doi: 10.1093/aje/136.7.787. [DOI] [PubMed] [Google Scholar]
  14. Laakso M., Suhonen M., Julkunen R., Pyörälä K. Plasma insulin, serum lipids and lipoproteins in gall stone disease in non-insulin dependent diabetic subjects: a case control study. Gut. 1990 Mar;31(3):344–347. doi: 10.1136/gut.31.3.344. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Misciagna G., Leoci C., Guerra V., Chiloiro M., Elba S., Petruzzi J., Mossa A., Noviello M. R., Coviello A., Minutolo M. C. Epidemiology of cholelithiasis in southern Italy. Part II: Risk factors. Eur J Gastroenterol Hepatol. 1996 Jun;8(6):585–593. doi: 10.1097/00042737-199606000-00017. [DOI] [PubMed] [Google Scholar]
  16. Norton J. J., Smith L. R., Hamper E. Diabetes mellitus and gallstones with special reference to insulin assay. Am J Gastroenterol. 1968 Sep;50(3):214–220. [PubMed] [Google Scholar]
  17. Reaven G. M. Banting lecture 1988. Role of insulin resistance in human disease. Diabetes. 1988 Dec;37(12):1595–1607. doi: 10.2337/diab.37.12.1595. [DOI] [PubMed] [Google Scholar]
  18. Scalzini A., Barni C., Stellini R., Sueri L. Fatal invasive aspergillosis during cyclosporine and steroids treatment for Crohn's disease. Dig Dis Sci. 1995 Mar;40(3):528–528. doi: 10.1007/BF02064361. [DOI] [PubMed] [Google Scholar]
  19. Schwille P. O., Hanisch E., Engelhardt W., Scholz D. Basal plasma somatostatin in biliary stone patients. Klin Wochenschr. 1984 Jun 15;62(12):595–597. doi: 10.1007/BF01728179. [DOI] [PubMed] [Google Scholar]
  20. Scragg R. K., Calvert G. D., Oliver J. R. Plasma lipids and insulin in gall stone disease: a case-control study. Br Med J (Clin Res Ed) 1984 Sep 1;289(6444):521–525. doi: 10.1136/bmj.289.6444.521. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Stout R. W., Balmer J. P., Henry R. W., Buchanan K. D. Plasma lipids and gastro-intestinal hormones in subjects with gallstones. Horm Metab Res. 1978 Jul;10(4):357–357. doi: 10.1055/s-0028-1095833. [DOI] [PubMed] [Google Scholar]

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