Metabolic dysfunction linked to surge in gallstone disease, finds study

A new study published in the Journal of Digestive Diseases found a significant increase in gallstone disease in the U.S., likely driven by the growing prevalence of metabolic disorders. Using data from the National Health and Nutrition Examination Survey, this study found strong associations between gallstones and conditions like diabetes, obesity, and metabolic dysfunction-associated steatotic liver disease (MASLD).

Gallstone disease can cause problems such as acute cholecystitis, cholangitis, and pancreatitis, even though some people with the condition have no symptoms. In order to reduce morbidity and mortality, rare but serious complications such gallstone ileus, gallbladder perforation, and Mirizzi syndrome must be treated promptly.

Ethnicity, advanced age, female gender, and lifestyle choices such a high-fat diet and sedentary activity are risk factors for gallstones. The incidence of gallstones is significantly increased by certain metabolic disorders, including diabetes mellitus (DM), obesity, and insulin resistance (IR). Thus, this study examined the relationship between gallstone disease and prevalent metabolic diseases in a nationally representative sample of Americans.

This research examined information gathered between 2017 and 2020 from the National Health and Nutrition Examination Survey (NHANES). 6,164 individuals, or 17,14,07,370 persons, who met the eligibility requirements were included. Multivariate logistic regression analysis were used to examine the relationships between gallstone disease and 6 metabolic illnesses while taking any confounding variables into consideration. 

The prevalence of gallstone disease was 10.9% overall, with a female preponderance (75.1% vs. 24.9%, p < 0.001) and an increase with age (mean age with vs. without gallstones: 56.435 years vs. 46.896 years, p < 0.001).

A higher risk of gallstone formation was significantly linked to non-alcoholic fatty liver disease (NAFLD), obesity, hypertension, and diabetes mellitus; the corresponding adjusted odds ratios (OR) were 1.523 (95% CI 1.180–1.965, p = 0.002), 1.733 (95% CI 1.265–2.374, p = 0.001), 1.466 (95% CI 1.203–1.785, p = 0.001), and 1.522 (95% CI 1.165–1.989, p = 0.003).

These correlations were stronger among females and those under 60 years old. There were no noteworthy correlations seen with either hyperlipidemia or hyperuricemia. Overall, gallstone disease is linked to obesity, diabetes mellitus, non-alcoholic fatty liver disease, and hypertension in American adults; this association is much stronger in women and those under 60. To assess the causal link and the underlying processes behind these disorders, more research is required.

Source:

Tang, Y. F., Su, Y. T., Liang, L. J., Feng, Y., Huang, X. J., Xiang, X. L., & Liang, Z. H. (2025). Association between metabolic dysfunction and gallstone disease in U.s. adults: An analysis of the National Health and Nutrition Examination Survey. Journal of Digestive Diseases, 26(3–4), 158–169. https://doi.org/10.1111/1751-2980.13349