The Lowest Prevalence of Cholelithiasis in the Americas - An Autopsy-based Study.
André Marangoni Asperti, Paulo Reis, Marcio Augusto Diniz, Mariana Dourado Pinto, Edinésio Carlos da Silva, Danilo Felipe Dias da Silva, Luiz Augusto Carneiro D'Albuquerque, Wellington Andraus
Author Information
André Marangoni Asperti: Faculdade de Medicina da Universidade de São Paulo, Departamento de Gastroenterologia, São Paulo/SP, Brasil.
Paulo Reis: Faculdade de Medicina da Universidade Federal do Tocantins, Departamento de Cirurgia, Departamento de Medicina Forense e Digestivo, Palmas/TO, Brasil.
Marcio Augusto Diniz: Faculdade de Medicina da Universidade de São Paulo, Departamento de Gastroenterologia, São Paulo/SP, Brasil.
Mariana Dourado Pinto: Faculdade de Medicina da Universidade Federal do Tocantins, Departamento de Cirurgia, Departamento de Medicina Forense e Digestivo, Palmas/TO, Brasil.
Edinésio Carlos da Silva: Faculdade de Medicina da Universidade Federal do Tocantins, Departamento de Cirurgia, Departamento de Medicina Forense e Digestivo, Palmas/TO, Brasil.
Danilo Felipe Dias da Silva: Faculdade de Medicina da Universidade Federal do Tocantins, Departamento de Cirurgia, Departamento de Medicina Forense e Digestivo, Palmas/TO, Brasil.
Luiz Augusto Carneiro D'Albuquerque: Faculdade de Medicina da Universidade de São Paulo, Departamento de Gastroenterologia, São Paulo/SP, Brasil.
Wellington Andraus: Faculdade de Medicina da Universidade de São Paulo, Departamento de Gastroenterologia, São Paulo/SP, Brasil.
OBJECTIVES: This study used autopsy to evaluate the prevalence of cholelithiasis and its associated risk factors in a population of healthy, young subjects who suffered a violent or natural death. METHODS: This study is a prospective evaluation of autopsies of 446 individuals from 2011 to 2013 in Brazil. Of that sample, 330 (74%) subjects died from violent deaths and 116 (26%) died naturally. The presence of biliary calculi, previous cholecystectomy, gender, age, ethnicity, body mass index (BMI) and alcohol use were evaluated. RESULTS: In the natural death group, 6.9% (95% CI 3.39 to 13.28) (3.08% of the male subjects and 11.76% of the female subjects) exhibited evidence of gallbladder disease. In the violent death group, only 2.12% (95% CI 0.96 to 4.43) (2.17% of the male subjects and 1.85% of the female subjects) of the subjects exhibited evidence of gallbladder disease. Age was correlated with the prevalence of gallbladder disease, but BMI was correlated with only gallbladder disease in the natural death group. CONCLUSIONS: This population has the lowest prevalence of cholelithiasis in the Americas. Dietary habits, physical activity, ethnicity, alcohol consumption and genetic factors may be responsible for this low prevalence.
