Pediatric Obesity and Gallstone Disease

Abstract
Objectives: The aim of the present study was to investigate the association between childhood and adolescent obesity, the risk of gallstones, and the potential effect modification by oral contraceptive use in girls. Methods: For this population-based cross-sectional study, measured weight and height, oral contraceptive use, and diagnosis of cholelithiasis or choledocholithiasis were extracted from the electronic medical records of 510,816 patients ages 10 to 19 years enrolled in an integrated health plan, 2007–2009. Results: We identified 766 patients with gallstones. The adjusted odds ratios (95% CI) of gallstones for under-/normal-weight (reference), overweight, moderate obesity, and extreme obesity in boys were 1.00, 1.46 (0.94%–2.27%), 1.83 (1.17%–2.85%), and 3.10 (1.99%–4.83%) and in girls were 1.00, 2.73 (2.18%–3.42%), 5.75 (4.62%–7.17%), and 7.71 (6.13%–9.71%), respectively (P for interaction sex × weight class P for interaction weight class × oral contraceptive use 0.023). Conclusions: Due to the shift toward extreme childhood obesity, especially in minority children, pediatricians can expect to face increasing numbers of children and adolescents affected by gallstone disease.