High Levels of Serum Triglyceride, Low-density Lipoprotein Cholesterol, Total Bile Acid, and Total Bilirubin are Risk Factors for Gallstones

Background: This study aimed to identify the risk factors for gallstone disease in the Hakka population in the Meizhou area of China. Methods: In total, 816 patients with gallstone disease and 818 control participants were included in the study, and their serum lipid levels were measured. Data on age, gender, and risk factors for gallstone disease (such as smoking and drinking history and the prevalence of hypertension) were recorded. Results: Of the 1,634 enrolled individuals, age 13 - 101 years, 727 were men and 907 were women. Serum triglyceride (TG) (p < 0.001), low-density lipoprotein-cholesterol (LDL-C) (p = 0.043), total bile acid (TBA) (p < 0.001), and total bilirubin (T-BIL) (p < 0.001) levels showed significant differences between the patients and controls. However, age, the proportion history of drinking and smoking; the prevalence of hypertension and diabetes mellitus; and serum levels of total cholesterol (TC), high-density lipoprotein-cholesterol (HDL-C), apolipoprotein A1 (Apo-A1), apolipoprotein B (Apo-B), and Apo-A1/Apo-B were similar between the two groups. The frequencies of gallstones in the common bile duct (chi(2) = 13.909, p < 0.001) and intrahepatic bile ducts (chi(2) = 8.289, p = 0.004) showed significant differences between male and female patients, but the distribution of gallstones of different sizes was similar between the two groups. Serum TBA (p < 0.001) and T-BIL (p < 0.001) levels were higher in patients with gallstones in the common bile duct than in those with gallstones in the gall bladder and intrahepatic bile ducts. Logistic regression analysis indicated that participants with high serum TG, LDL-C, TBA, and T-BIL levels had a significantly higher risk of gallstone disease. Conclusions: High serum levels of TG, LDL-C, TBA, and T-BIL are found to be the main risk factors for gallstone formation in our study.