DOI QR코드

DOI QR Code

Prevalence and Risk Factors of the Gallbladder Polyps Diagnosed by Ultrasound

복부초음파검사로 진단된 담낭용종의 유병률과 위험인자 분석

  • LEE, Mi-Hwa (Department of Radiological science, Catholic University of Daegu) ;
  • Cho, Pyong-Kon (Department of Radiological science, Catholic University of Daegu) ;
  • Kwon, Duck-Moon (Department of Diagnostic Radiology, Daegu Health College)
  • 이미화 (대구가톨릭대학교 방사선학과) ;
  • 조평곤 (대구가톨릭대학교 방사선학과) ;
  • 권덕문 (대구보건대학교 방사선과)
  • Received : 2015.04.29
  • Accepted : 2015.06.03
  • Published : 2015.06.30

Abstract

This study was designed to determine the prevalence of gallstones in the last three years and evaluate the associated risk factors in the population who underwent health screening. Although there are many studies reporting the prevalence and risk factors of GB polyp, the results varied among each report. The aims of this study were to evaluate the prevalence rate and risk factors of GB polyp, colon polyp and fatty liver in the population who underwent health screening. The study population consisted of 4,877 visited the health promotion center in Dalseogu, Daegu in Korea from January 2011 to December 2013. Each participant in the study had their biliary system gallbladder examined using ultrasonography. The prevalence of GB polyp was evaluated along with age, gender, metabolic syndrom, body mass index (BMI), Fatty liver, Colon polyp. A showed of total 383 (7.9%) people were found to have GB polyps. The prevalence of sex among 256 (9.8%) patients men and 127 (5.6%) women which showed significantly higher in male than in female subjects(p=0.001). The mean size of the GB polyps 4.92 mm (1.6-17 mm). The sizes of most GB polyps (73.6%) were less than 10 mm in diameter. 122 subjects (31.28%) had multiple GB polyps which 2 or more polyps and 261 subjects (68.2%) had single polyp. Independent risk factors related with GB polyp were male gender (OR 0.551, p<0.001), overweight that BMI above $23kg/m^2$ (OR 0.713, p=0.002) triglyceride (OR 0.571, P<0.001), metabolic syndrome (OR 0.049, p=0.033) and colon polyp (OR 1.409, p=0.002). In spite of the conclusion, the prevalence GB polyp was higher than previous Korea and other country reports. The GB polyp in a healthy population was results as 7.9%. The risk factors of GB polyps were found to be male, being overweight, triglyceride, metabolic syndrome and colon polyp. Not only the subject of a health examination is needed but, a further study of the general public when possible.

인구 고령화에 따른 암에 대한 관심 증가로 건강 검진을 받는 수검자가 늘고 있으며, 담낭용종의 유병률과 체질량 지수, 성별, 나이, 대사증후군 등의 위험인자에 대한 몇몇 연구가 있으나 본 연구는 최근 3년간의 담낭용종의 유병률과 대장용종 유무, 지방간 등의 다른 위험인자를 알아보고자 하였다. 2011년 1월에서 2013년 12월까지 대구지역 종합검진전문병원에서 건강검진을 받은 4,877명을 대상으로 성별과 나이를 조사하고, 키, 몸무게, 공복혈당, 간기능 및 기본 지질검사를 하였다. 복부초음파검사를 통해 담낭용종을 진단하고 지방간, 대장 내시경 결과 용종의 유무를 분석하였다. 분석결과 담낭용종이 발견된 경우는 383명(7.9%)으로 남자 256명(9.8%), 여자 127명(5.6%)으로 남자에서 담낭용종 유병률이 의미 있게 높았다(p<0.001). 연령별 담낭용종 유병률은 40대에서 3.50%로 가장 높게 나타났고 유의하게 나타나지 않았다. 담낭용종 크기는 평균 4.92 mm (1.6-17 mm)로 10 mm 이하가 73.6% 나타났다. 383명 중 261명(68.2%)이 단발성 용종, 122명(31.28%)이 2개 이상의 다발성 용종으로 타나났다. 남성 (OR 0.551, p<0.001), 과체중 (OR 0 .713, p=0.002), 중성지방 (OR 0 .571, p<0.001), 대사증후군 (OR 0 .049, p=0.033), 대장 용종 유무 양성 (OR 1.409, p=0.002)등이 담낭용종 발생에 영향을 미치는 독립인자로 선정되었다. HBsAg 양성은 담낭용종 발생에 관련 있는 위험인자가 아니었다. 결론적으로 본 연구는 담낭용종이 유병률은 과거보다 높은 7.9%로 나타났다. 남성, 과체중, 중성지방, 대사증후군, 대장용종이 담낭용종의 위험인자였다. 향후 건강검진 수검자 대상뿐만 아니라 일반국민을 대상으로 추가적인 검사가 필요하다고 사료되고, 담낭 절제술을 받아서 조직학적으로 확인된 경우를 조사 할 필요가 있겠다.

Keywords

References

  1. Lin WR, Lin DY, Tai DI, Hsieh SY, Lin CY: Sheen IS et al Prevalence of and risk factors for gallbladder polyps detected by ultrasonography among health Chinese: analysis of 34,669 cases. J Gastroenterol Hepatol, 23, 965-969, 2008 https://doi.org/10.1111/j.1440-1746.2007.05071.x
  2. Chattopadhyay D, Lochan R, Balupuri S, Gopinath BR, Wynne KS: Outcome of gallbladder polypoidal lesions detected by transabdominal ultrasound scanning: a nine-year experience. World J Gastroenterol, 11, 2171-2173, 2005 https://doi.org/10.3748/wjg.v11.i14.2171
  3. Shebl FM, Andreottij G., Meyer TE, Gao YT, Rashid A, Yu K, et al.: Metabolic syndrome and insulin resistance in relation to biliary tract cancer and stone risk. a population-based study in Shanghai. China Br J Cancer, 105, 1424-1429, 2011 https://doi.org/10.1038/bjc.2011.363
  4. Benign tumors and pseudotumors of the gallbladder: Report of 180cases. Nov, 90(5), 42-32, 1970
  5. Aldridge MC, Bismuth H., Gallbladder cancer: the polyp-cancer sequence. Br J Surg, 77, 363-4, 1990 https://doi.org/10.1002/bjs.1800770403
  6. Lee KF, Wong J, Li JC, Lai PB: Polypoid lesions of the gallbladder. Am J Surg, 188, 186-90, 2004 https://doi.org/10.1016/j.amjsurg.2003.11.043
  7. Sheth S, Bedford A, Chopra S: Primary gallbladder cancer : recongnition of risk factors and role of prophylactic cholecystectomy. Eur J Radiol 62, 175-9, 2007 https://doi.org/10.1016/j.ejrad.2007.01.037
  8. Segawa K, Arisawa T, Biwa Y, et al.: Prevalence of gallbladder polyps among apparantly healthy Japanese: Ultrasonographic study. Am J Gastroenterol, 87, 630-633, 1992
  9. Kim SY, Lee HS, Lee YS, Chung KW, Jang BK, Chung WJ, et al.: Prevalence and risk factors of gallbladder polyp in adults living in Daegu, and risk factors of gallbladder polyp in adults living in Daegu and Gyeongbuk Provinces. Korean J Gastroenterol, 34-350, 2006
  10. Jorgensen T, Jensen KH: polyps in the gallbladder : A prevalence study. Scand J Gastroenterol, 25, 281-6, 1990
  11. Seung Beom Lee, MD, HEE Cheol Kang, PhD: Prevalence of Gallbladder Polyp in Adults in Korea. Korean J Fam Med, 30, 39-45, 2009 https://doi.org/10.4082/kjfm.2009.30.1.39
  12. Kono S, Shinchi K, Todoroki I, Honjo S, Sakurai Y, Wakabayashi K, Imanishi K, Nishikaw H, Ogawa S, Katsurada: Gallstone disease among Japanese men in relation to obesity, glucose intolenrance, exercise alcohol use and smoking. scand J Gastroenterol, 30, 372, 1995
  13. Lu SN, Chang WY, Wang, LY, Hsieh MY, Chuang WL, Chen SC, Su, WP, Tai, TY, Wu MM, Chen CJ: Risk factors for gallsones among Chiness in Twain. A community sonographic study. J Chin Gastroenterol, 12, 524, 1990
  14. Jong Kyun Lee, Poong Lyul Rhee, Joon Hyeok Lee, Kyu Taek Lee, et al.: Prevalence and Risk Factors of Gallstone in Health Screening People. Korean J Gastroenterol, 29, 85, 1997
  15. Chen CY, Lu CL, Chang FY, Lee SD: Risk factors for gallbladder polyps in the Chinese population. Am J Gastroenterol, 92, 2006, 1997
  16. Lim SH, Kim DH, Park MJ, et al.: Is Metabolic Syndrome One of the Risk Factors for Gallbladder Polyps Found by Ultrasonography during Health Screening? Gut liver, Dec:1(2), 138-44, 2007 https://doi.org/10.5009/gnl.2007.1.2.138
  17. Mi Hwa Lee, Pyong Kon Cho, Duck Moon Kwon: Prevalence and risk factors of gallstones on the abdominal sonography. Journal of Korean Society of Radiological Technology, 37(4), 287-94, 2014
  18. Jorgensen T, Jensen KH: Polyps in the gallbladder : A prevalence study. Scand J Gastroenterol, 25, 251, 1990
  19. Schinchi K, Kono S, Honjo S, Imanishi K, Hirohata T: Epidemiology of gallbladder polyps : an ultrasonographic study of male self-defense officals in Japan. Scand J Gastroenterol, 29, 7, 1994
  20. World Health Organization: Reducing Risks-Promoting Healthy Life. World Health Report, 2002
  21. Third Report of the National Cholesterol Education Program(NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation, 106, 3143-421, 2002
  22. Jorgensen T: Prevalence of gallstones in a Danish population. Am J Epidemiol, 126, 912, 1987 https://doi.org/10.1093/oxfordjournals.aje.a114728
  23. Christensen AH, Ishak KG: Benign tumors and pseudotumors of the gallbladder. Report of 180cases. Arch Pathol, 90, 423, 1970
  24. Tabah EJ, McNeer G: Papilloma of the gallbladder with in situ carcinoma. Sugery, 34, 57, 1953
  25. Carrera GM, Ochesner SF: Polypoid mucosal lesions of gallbladder. JAMA, 666, 888, 1958
  26. Qing Xu, Lian-yuan Tao, Qiao Wu, Fei Gao, Fen-liang Zhang: Prevalencs of and risk factors for biliary stones and gallbladder polyps in a large Chinese population. Hepato-Pancreato-Biliary Association, 14, 373-381, 2012 https://doi.org/10.1111/j.1477-2574.2012.00457.x
  27. Yang HL, Sun YG, Wang Z: Polypoid lesions of the gallbladder: diagnosis and indications for surgery. Br J S, 79, 227-9, 1992 https://doi.org/10.1002/bjs.1800790312
  28. Lim S., Park KS, Lee HK, Cho SI: Changeds in the characteristics of metalbolic syndrome in Korean over the peroid 1998-2001 as determined by Korean National Health and Nutrition Examination Surveys. Diabetes Care, 28, 1810-2, 2005 https://doi.org/10.2337/diacare.28.7.1810
  29. Salmenkivi K, Cholesterosis of the Gall-Bladder: A Clinical Study Based on 269 Cholecystectomies. Acta Chir Scand Suppl, 102, SUPPL 3241-93, 1964
  30. Tilvis RS, Aro J, Strandberg TE, Lempinen M., Miettinen TA: Lipid comosition of bile and gallbladder mucosa in patients with acalculous cholesterolosis. Gastroenterology, 82, 60-15, 1982
  31. Shim SG LK, Lee Jk: Prevalence and risk factors of gallbladder polyps in health screening subjects. Korean J Med, 57, 1014-20, 1999
  32. Horn RC, Jr: Malignant potential of polypoid lesions of the colon and rectum. Cancer, 28, 146-52, 1971 https://doi.org/10.1002/1097-0142(197107)28:1<146::AID-CNCR2820280130>3.0.CO;2-G
  33. Goldman H, Ming S, Hickock DF: Nature and significiance of hyperplastic polyps of the human colon. Arch Pathol, 89, 349-54, 1970