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Jo, Lee, Choi, Han, Choi, Kang, Kim, Lim, Koh, and Lee: Is the Prevalence of Gallbladder Polyp Different between Vegetarians and General Population?
Original Article

Korean J Gastroenterol 2015;66(5):268-273.

Published online: 4 October 2015

DOI: https://doi.org/10.4166/kjg.2015.66.5.268

Is the Prevalence of Gallbladder Polyp Different between Vegetarians and General Population?

Hee Bum Jo, Jun Kyu Lee, Min Young Choi, In Woong Han1, Han Seok Choi, Hyoun Woo Kang, Jae Hak Kim, Yun Jeong Lim, Moon-Soo Koh, Jin Ho Lee

Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, Korea

1Department of Surgery, Dongguk University Ilsan Hospital, Goyang, Korea

Correspondence to: Jun Kyu Lee, Department of Internal Medicine, Dongguk University Ilsan Hospital, 27 Dongguk-ro, Ilsandong-gu, Goyang 10326, Korea. Tel: +82-31-961-7750, Fax: +82-31-961-9390, E-mail: jeromee1971@yahoo.co.kr

Received 15 August 2015       Revised 24 September 2015       Accepted 12 October 2015

Copyright © 2015 Korean Ophthalmological Society

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background/Aims

Gallbladder polyps (GBP) are a common clinical finding that can express malignant potential. The aim of this study was to evaluate whether vegetarianism protects against GBP, together with other putative risk factors.

Methods

A retrospective, cross-sectional study was conducted with subjects who received a health check-up from July 2005 to December 2011. Korean Buddhist priests, who are obligatory vegetarians by religious belief, were identified as vegetarians (vegetarian group) and compared with a non-vegetarian control group sampled from those coming for health check-ups at the same institution.

Results

Out of 18,483 subjects, GBP were found in 810 (4.4%). Although GBP tended to be less common in the vegetarian group (23 [3.5%] out of 666) than in control group (787 [4.4%] out of 17,817), the difference was insignificant statistically (p=0.233). By logistic regression, old age (OR=1.61, 95% CI=1.19–2.26 for 30–39 years; OR=1.47, 95% CI=1.08–1.98 for 40–49 years), male gender (OR=1.51, 95% CI=1.31–1.75), high BMI (OR=1.18, 95% CI=1.00–1.39 for ≥23.0 kg/m2 and ＜25.0 kg/m2) and HBsAg positivity (OR=1.53, 95% CI=1.19–1.98) were independent risk factors of GBP.

Conclusions

GBP was significantly associated with old age, male gender, high BMI and HBsAg positivity, but not with vegetarianism.

Keywords: Gallbladder polyp, Vegetarian diet, Metabolic syndrome, Risk factors

References

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Fig. 1.
Subject selection process.
kjg-66-268f1.tif
Table 1.
Comparison of Baseline Characteristics between Vegetarian and Control Group
Characteristic Vegetarian group (n=666) Control group (n=17,817) p-value
Age (yr) 49.3±10.0 43.4±10.7 ＜0.001
Gender (male:female) 366:300 10,023:7,794 ＜0.001
BMI (kg/m2) 24.3±3.3 23.4±3.2 0.021
Current smoking 0 (0) 3,214 (18.0) ＜0.001
Alcohol consumption 0 (0) 6,542 (36.7) ＜0.001
Systolic blood pressure (mmHg) 122.4±17.7 119.6±15.7 0.012
Diastolic blood pressure (mmHg) 78.4±12.5 77.7±12.2 0.112
HBsAg positivity 26 (3.9) 998 (5.6) 0.614
Anti-HCV positivity 5 (0.8) 152 (0.9) 0.765
HbA1c (%) 5.6±0.8 5.5±0.7 0.020
Total cholesterol (mg/dL) 196.2±38.8 194.4±35.8 0.229
HDL-C (mg/dL) 53.0±13.2 56.3±14.4 0.002
TG (mg/dL) 144.3±58.4 134.2±67.4 0.037
AST (IU/L) 28.8±18.5 24.3±19.8 0.022
ALT (IU/L) 29.9±15.6 24.9±14.2 0.015
GGT (IU/L) 34.8±24.3 30.0±20.5 0.004
CEA (ng/mL) 1.9±1.3 1.9±1.4 0.552
CA 19–9 (IU/mL) 10.9±5.3 10.5±8.5 0.552
No gallbladder polyp 23 (3.5) 787 (4.4) 0.233

Values are presented as mean±SD or n (%).

HbA1c, hemoglobin A1c; HDL-C, HDL cholesterol; TG, triglyceride.

Table 2.
Characteristics of Gallbladder Polyps
Characteristic Vegetarian group (n=23) Control group (n=787) p-value
Mean size (mm) 4.6±2.6 4.8±2.3 0.999
Size classification (mm)      
＜5 15 (65.2) 511 (64.9) 0.862
5–10 7 (30.5) 239 (30.4) 0.999
≥10 1 (4.3) 37 (4.7) 0.901
Mean number 1.7±1.3 1.8±1.2 0.780
Multiplicity     0.865
Single 16 (69.6) 556 (70.6)  
Multiple 7 (30.4) 231 (29.4)  
Cholecystectomy 0 (0) 32 (4.1) NA
Cholesterol polyp 0 (0) 28 (87.4)  
Adenoma 0 (0) 2 (6.3)  
Miscellaneous 0 (0) 2 (6.3)  

Values are presented as mean±SD or n (%).

NA, not available.

Table 3.
Univariate Analysis for Possible Risk Factors for Gallbladder Polyp
Variable Gallbladdder polyp OR (95% CI) p-value
Yes (n=810) No (n=17,673)
Age (yr)        
＜30 39 (4.8) 1,381 (7.8) 1.00  
30–39 346 (42.7) 6,689 (37.8) 1.81 (1.35–2.43) ＜0.001
40–49 280 (34.6) 5,566 (31.5) 1.78 (1.32–2.39) ＜0.001
50–59 101 (12.5) 2,485 (14.1) 1.41 (1.01–1.95) 0.042
≥60 44 (5.4) 1,401 (7.8) 0.97 (0.66–1.42) 0.867
Gender        
Male 542 (66.9) 9,638 (54.5) 1.69 (1.48–1.92) ＜0.001
Female 268 (33.1) 8.035 (45.5) 1.00  
BMI (kg/m2)        
＜18.5 20 (2.5) 992 (5.6) 0.50 (0.33–0.74) ＜0.001
≥18.5, ＜23.0 304 (37.5) 7,416 (42.0) 1.00  
≥23.0, ＜25.0 222 (27.4) 4,116 (23.3) 1.32 (1.13–1.54) ＜0.001
≥25.0, ＜30.0 242 (29.9) 4,679 (26.5) 1.26 (1.08–1.47) 0.003
≥30.0 22 (2.7) 470 (2.6) 1.18 (0.80–1.73) 0.411
Systolic blood pressure (mmHg) 122.4±17.7 119.6±15.7 1.80 (0.90–3.59) 0.095
Diastolic blood pressure (mmHg) 78.4±12.5 77.7±12.2 1.63 (1.19–2.24) 0.002
HBsAg positivity 53 (6.5) 741 (4.2) 1.59 (1.23–2.05) ＜0.001
Anti-HCV positivity 6 (0.7) 115 (0.6) 1.17 (0.57–2.39) 0.664
HbA1c (%) 5.6±0.8 5.5±0.7 0.94 (0.80–1.11) 0.470
Total cholesterol (mg/dL)        
＜200 482 (59.5) 10.581 (59.9) 1.00  
≥200, ＜240 239 (29.4) 5,298 (30.0) 0.99 (0.86–1.14) 0.912
≥240 89 (11.1) 1,803 (10.1) 1.09 (0.89–1.34) 0.396
HDL-C (mg/dL)        
＜40 (M), ＜50 (F) 224 (27.7) 4,304 (24.4) 1.34 (0.73–1.96) 0.013
≥40 (M), ≥50 (F) 586 (72.3) 13,369 (75.6) 1.00  
TG (mg/dL)        
＜150 552 (68.1) 12,611 (71.4) 1.00 0.026
≥150 258 (31.9) 5,062 (28.6) 1.16 (1.02–1.33)  
AST (IU/L) 27.6±15.5 27.5±14.1 1.00 (0.99–1.01) 0.546
ALT (IU/L) 28.1±13.6 25.8±13.4 1.26 (0.85–1.86) 0.210
GGT (IU/L) 32.1±19.5 33.8±20.3 1.01 (0.84–1.22) 0.388
CEA (ng/mL) 1.9±1.3 2.0±1.5 1.12 (0.85–1.48) 0.434
CA19–9 (IU/mL) 10.9±5.3 11.2±8.5 0.96 (0.64–1.43) 0.835
Vegetarianism 23 (2.8) 643 (3.6) 0.78 (0.51–1.18) 0.233

Values are presented as n (%) or mean±SD.

HbA1c, hemoglobin A1c; HDL-C, HDL cholesterol; TG, triglyceride.

Table 4.
Multivariate Analysis for Possible Risk Factors for Gallbladder Polyp
OR (95% CI) p-value
Age (yr)    
＜30 1.00  
30–39 1.61 (1.19–2.26) 0.002
40–49 1.47 (1.08–1.98) 0.013
50–59 1.15 (0.83–1.61) 0.405
≥60 0.83 (0.56–1.22) 0.343
Gender    
Male 1.51 (1.31–1.75) ＜0.001
Female BMI (kg/m2) 1.00  
＜18.5 0.55 (0.37–0.82) 0.004
≥18.5, ＜23.0 1.00  
≥23.0, ＜25.0 1.18 (1.00–1.39) 0.047
≥25.0, ＜30.0 1.11 (0.70–1.55) 0.239
≥30.0 1.05 (0.70–1.55) 0.828
Diastolic blood pressure 1.25 (0.89–1.74) 0.195
(mmHg)    
HBsAg positivity 1.53 (1.19–1.98) ＜0.001
HDL-C (mg/dL)    
＜40 (M), ＜50 (F) 0.97 (0.84–1.14) 0.736
≥40 (M), ≥50 (F) 1  
TG (mg/dL)    
＜150 0.94 (0.81–1.10) 0.433
≥150 1  

Values are presented as n (%) or mean±SD.

HDL-C, HDL cholesterol; TG, triglyceride.

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