The Analysis Of Relative Risk Factors In Female Cholelithiasis

The first part:The analysis of risk factors for Cholelithiasis in womenBackground:cholelithiasis is a common disease with a long history,spreading all around the world.Nowadays,with the development of economics,the life-style and diet structure of people in China has changed continuously and the morbidity of cholelithiasis is increasing year by year.The main reason for the formation of gallstone is the long-term interaction of various factors,such as the change of ingredient in bile and dysfunction of biliary tract.Gallstones can be divided into cholesterol gallstones,pigment stones and complex stones according to the proportion of content.On the other hand,according to the position,gallstones can be divided into intrahepatic or extrahepatic stones and cholecystolithiasis.When stones obstructed the bile duct sometimes,it may lead to a verity of complications including biliary pancreatitis and perforation of biliary duct,and the repeated stimulation of stones may contribute to the development of cancer.What is more,there are many researchers suggest that the morbidity of cholelithiasis in women is significantly high than men which leads to more serious effect.In conclusion,since cholelithiasis is a wide-spread and serious public health problem,we should take a comprehensive analysis to study the risk factors of cholelithiasis in women and therefore preserve the health of the public.This research collected medical records in Shandong University of Qilu hospital to study the risk factors of cholelithiasis in women,which can guide the clinical works.Methods:Retrospective analysis 100 female patients with gallstones diagnosed by pathology and 100 female non-patients are matched from Qilu hospital between January 2013 and December 2016.The information is consisted of general situation,family history,personal history,exogenous estrogen intake,previous history,BMI and index of blood.Through single-factor analysis and multiple-factor analysis,we study the related risk factors of cholelithiasis in women.Results:The average age of patient group is 50.14±11.42 and the control group is about 51.26±12.04.Through single-factor and multiple-factor analysis.we get the result that the RR value of exogenous estrogen intake is 9.77(95%CI:4.08-23.39),indicating that it is the independent risk factor of cholelithiasis.Also the BMI with RR value of 12.99(95%CI:5.98-28.20)is also the independent risk factor of cholelithiasis.Both the parity and family history are risk factors of cholelithiasis in women.However,the relationship among gastrointestinal surgery,diabetes,history of hepatitis,smoke,drink,total cholesterol,triglyceride,ALT,AST,AKP.GGT and cholelithiasis have no statistical significance.Conclusion:The research suggests that the independent risk factors of cholelithiasis in women are exogenous estrogen intake and BMI.We should take more measures to control this two factors to prevent this disease,such as losing weight,doing more exercise and using estrogen more cautiously.Whereas another factors have not shown significantly meanings and more data information is needed to put forward reasonable opinions to prevent the development of cholelithiasis.The second part:The research of the relationship between exogenous estrogen and cholelithiasisBackground:Cholelithiasis is a common disease in China,which is resulted from the long-term influence of various factors including the change of ingredient in bile and dysfunction of biliary tract.There are many risk factors of cholelithiasis,such as age,obesity,sex and so on.Among this,the association between exogenous estrogen intake and cholelithiasis risk has been reported in several epidemiological studies,including oral contraceptive(OC)and hormone replacement therapy(HRT),while the results were controversial.This study aimed to perform a comprehensive meta-analysis of this issue and a case-control study,which are significant to develop a better strategy in clinical work.Methods:PUBMED,EMBASE,and Cochrane library database were searched up to October 2016.Then we extracted data from eligible studies,relative risks(RRs),and/or odds ratios(ORs)with 95%confidence intervals(95%CIs)for the highest versus lowest categories of intake were adopted.Either a fixed-or a random-effects model was adopted to estimate overall RRs or ORs.Besides,subgroup and publication bias analyses were applied to explain the heterogeneity.An original study was also conducted to verify our conclusion.Results:A total of 19 studies in the domestic and abroad with approximately 556,620 participants were included in this meta-analysis.The pooled RR of exogenous estrogen for the highest versus the lowest categories was 1.59(95%CI:1.44-1.75),indicating that intake of exogenous estrogen was positive associated with the cholelithiasis.However,the pooled RR of OC intake and cholelithiasis risk was 1.19(95%CI:0.97-1.45),and the RR for HRT was 1.79(95%Cl:1.61-2.00).In case-control study,the OR for OC was 1.23(95%Cl:0.93-1.62)and the OR for HRT was 1.84(95%CI:1.39-2.43).Conclusion:The HRT was positively associated with the cholelithiasis risk,and the OC will not increase the risk of cholelithiasis.This conclusion suggests that we should pay much attention to the health of gallbladder in women with hormone replace therapy.