A CROSS SECTIONAL STUDY OF CHOLELITHIASIS ON ULTRASOUND: ASSOCIATION WITH DEMOGRAPHIC AND RISK FACTORS

Abstract

Objective: To evaluate the prevalence of cholelithiasis as detected by ultrasound and to assess its association with various demographic variables (Age, gender) and risk factors (diabetes, high cholesterol, hypertension, BMI).

Aim of study: Ultrasound as reliable diagnostic tool, a focused evaluation of diagnostic patterns of cholelithiasis in relation to the factors such as age, gender, BMI, co morbid conditions like diabetes, hypertension are essential for detection and prevention strategies in Pakistan.

Methodology: A cross-sectional observational study was conducted in the Radiology Department of Social Security hospital lahore over a period of 15th April 2025 to 20th August 2025 to evaluate the prevalence of cholelithiasis as detected by ultrasound and its association with demographic and risk factors. The study population was included adult patients aged 18 years and above, of both sexes, who are referred for abdominal ultrasound during the study period and who provide informed consent. Patients with a history of cholecystectomy, pregnant women, and those with incomplete clinical data was excluded from the study. A standardized data collection form was used to record risk factors, such as history of diabetes mellitus, hypertension, high cholesterol, and body mass index (BMI), as well as demographic information, such as age and gender. Measurements of height and weight was recorded and used to calculate BMI. The collected data was analyzed using statistical software such as SPSS. Descriptive statistics was used to summarize the characteristics of the study population. The prevalence of cholelithiasis was expressed as a percentage. Associations between cholelithiasis and categorical variables was assessed using the Chi-square test. A p-value of less than 0.05 will be considered statistically significant.

Result: Among the 109 participants assessed by ultrasound for cholelithiasis, the highest prevalence was observed in the 40–60 years age group (53.2%), followed by 18–40 years (28.4%) and 60–80 years (18.3%), with no significant correlation between age and number of gallstones (p = 0.684). Females constituted the majority (80.7%), while males accounted for 19.3%; however, the number of gallstones was not significantly associated with gender (p = 0.248). A positive family history of gallstones was reported in 56.0% of participants, yet no significant correlation was found with the number of gallstones (p = 0.079). Regarding BMI, 57.8% had abnormal BMI, which showed a statistically significant association with multiple gallstones on ultrasound (p = 0.039). High cholesterol was present in 58.7% of cases, but this did not correlate significantly with gallstone number (p = 0.310). Similarly, no significant associations were found between number of gallstones and diabetes (25.7% diabetic; p = 0.295) or hypertension (61.5% hypertensive; p = 0.517).

Conclusion: Among the evaluated demographic and risk factors, only BMI showed a statistically significant association with the severity and multiplicity of gallstones on ultrasound. Obesity was found to be a key contributing factor, indicating that it not only increases the risk of developing cholelithiasis but also its severity.