Korean J Intern Med > Volume 40(4); 2025 > Article
ORIGINAL ARTICLE
Gastroenterology
Korean J Intern Med. 2025;40(4):584-591.         doi: https://doi.org/10.3904/kjim.2025.090
Prevalence of cholesterol gallstones in a Korean population over a 14-year period
Gyumin Lee1, Jeong Yoon Suh1, Junyeol Kim2, Tae Young Park2,3, Jae Hyuk Do3, Yoo Shin Choi4, Seung Eun Lee4, Tae Yoon Lee5, Hyun Kang6, and Hyoung-Chul Oh3
1Department of Medicine, Chung-Ang University College of Medicine, Seoul, Korea
2Department of Internal Medicine, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, Korea
3Division of Gastroenterology, Chung-Ang University College of Medicine, Seoul, Korea
4Department of Surgery, Chung-Ang University College of Medicine, Seoul, Korea
5Division of Gastroenterology, Konkuk University Hospital, Konkuk University School of Medicine, Seoul, Korea
6Department of Anesthesiology and Pain Medicine, Chung-Ang University College of Medicine, Seoul, Korea
Corresponding Author: Hyoung-Chul Oh  , Tel: +82-2-6299-3149, Fax: +82-2-6299-1911, Email: ohcgi@cau.ac.kr
Received: March 21, 2025;   Accepted: March 29, 2025.
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Abstract
Background/Aims: The incidence of cholesterol gallstones has increased in the last few decades. This study aimed to evaluate the prevalence of cholesterol gallstones in Korea over a 14-year period, analyze any changes, and identify the predisposing factors.
Methods: A total of 3,909 patients underwent cholecystectomy for gallstones over the 14-year period and were considered for inclusion in this study. Patients were divided into cholesterol and pigment gallstone groups based on gallstone composition, as determined by Fourier Transform Infrared spectroscopy. Patient characteristics were compared between the two groups.
Results: After the exclusion of 259 patients with mixed type gallstones, 3,650 patients were finally included in this study; 2,038 (55.8%) with cholesterol gallstones and 1,612 (44.2%) with pigment gallstones. The proportion of cholesterol gallstones over the 14-year period was 53.8% of the study population as a whole and 77.5% of individuals aged < 50 years. The multivariate analysis revealed that cholesterol gallstones were associated with an age < 50 years, female sex, central obesity, absence of chronic liver diseases, and diabetes mellitus. High density lipoprotein-cholesterol levels showed a tendency toward an association with cholesterol gallstones.
Conclusions: The prevalence of cholesterol gallstones in Korea plateaued 53.8% during the 14-year period. However, given the increasing incidence of cholesterol gallstones among younger individuals, the relative prevalence of cholesterol gallstones may increase in the future.
Keywords: Cholecystolithiasis ; Cholesterol ; Prevalence ; Korea

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