Association between gallstone disease and ischemic stroke in Korea

Background & Objectives: In Korea, stroke incidence is projected to rise due to the rapid aging of the Korean population. Additionally, gallstone disease incidence is increasing in Korea, due to dietary and westernized lifestyle. In this cross-sectional study, we investigated the association between gallstone disease and ischemic stroke in Korea. Methods: We included 566 patients aged 40-89 years who underwent abdominal ultrasound or abdominal computed tomography at the VHS Medical Center between January 2008 and December 2010. Patient records were reviewed for the presence of hypertension, diabetes mellitus, dyslipidemia, atrial fibrillation, obstructive coronary artery disease, and smoking history. The associations between risk factors, including gallstone disease, and ischemic stroke were analyzed using Pearson's chi-square tests. Multiple logistic regression analysis was performed with age, sex, smoking history, hypertension, obstructive coronary artery disease, and atrial fibrillation as covariates. Results: Age, sex, hypertension, obstructive coronary artery disease, atrial fibrillation, and smoking history were identified as significant risk factors for ischemic stroke (p-value < 0.05). Gallstone disease demonstrated an unadjusted odds ratio for ischemic stroke of 2.171 (95% confidence interval, 1.264-3.729); after adjustment for risk factors, the odds ratio was 2.015 (95% confidence interval, 1.151-3.528). Conclusion: In Korean patients, gallstone disease and ischemic stroke are correlated. Despite an unclear causality, the risk for ischemic stroke is significantly increased in patients with gallstone disease, even after adjusting for various confounders. Clinicians should be aware of the possibility of ischemic stroke in patients with gallstone disease, and should manage and educate patients accordingly.