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Pediatric Obesity and Gallstone Disease

Koebnick, Corinna*; Smith, Ning*; Black, Mary Helen*; Porter, Amy H.; Richie, Bradley A.; Hudson, Sharon*; Gililland, Deborah§; Jacobsen, Steven J.*; Longstreth, George F.*

Journal of Pediatric Gastroenterology and Nutrition: September 2012 - Volume 55 - Issue 3 - p 328–333
doi: 10.1097/MPG.0b013e31824d256f
Hepatology and Nutrition

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 <0.001). Among girls, oral contraceptive use was associated with higher odds for gallstones (odds ratio 2.00, 95% CI 1.66%–2.40%). Girls who used oral contraceptives were at higher odds for gallstones than their counterparts in the same weight class who did not use oral contraceptives (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.

*Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena

Kaiser Permanente Baldwin Park Medical Center, Baldwin Park

Kaiser Permanente Riverside Medical Center, Riverside

§Kaiser Permanente Fontana Medical Center, Fontana, CA.

Address correspondence and reprint requests to Corinna Koebnick, PhD, Department of Research and Evaluation, Kaiser Permanente Southern California, 100 Los Robles, 2nd Floor, Pasadena, CA 91101 (e-mail:

Received 30 November, 2011

Accepted 26 January, 2012

Research funding was provided to C.K. by the National Institute of Diabetes and Digestive and Kidney Disorders (NIDDK, R21DK085395) and Kaiser Permanente Direct Community Benefit Funds.

The authors report no conflicts of interest.

Copyright 2012 by ESPGHAN and NASPGHAN