A retrospective administrative database analysis of the association between clonorchiasis or helminthiasis and the development of cholelithiasis

Abstract

Purpose: Parasite infestation (PI) is reportedly related to intrahepatic stones (IHSs) and common bile duct (CBD) stones. This study assessed the association of clonorchiasis and helminthiasis with the sub-types of cholelithiasis.

Methods: The study cohort consisted of 713 patients who were aged ≥20 years with clonorchiasis or helminthiasis for the first time between 2000 and 2010 from the National Health Insurance Research Database. The controls without clonorchiasis and helminthiasis were randomly selected with a 1:1 propensity score matching. All patients were followed up until the end of 2011 to measure the incidence of cholelithiasis.

Results: The risks of cholelithiasis in the clonorchiasis (adjusted hazard ratio [aHR] = 3.72, 95% confidence interval [CI] = 2.01–6.90) and helminthiasis (aHR = 2.27, 95% CI = 1.25–4.16) were higher than in the non-PI cohort. Patients with clonorchiasis had increased risks of gallstones without bile duct stones (aHR = 3.13, 95% CI = 1.54–6.39) and bile duct stones without gallstones (aHR = 4.75, 95% CI = 1.23–18.4). Patients with helminthiasis had an increased risk of gallstones without bile duct stones (aHR = 2.20, 95% CI = 1.11–4.33), but no higher risk of bile duct stones without gallstones was observed in helminthiasis (aHR = 2.22, 95% CI = 0.54–9.06), despite its high aHR. Neither clonorchiasis nor helminthiasis had an increased risk of concomitant gallstones and bile duct stones.

Conclusion: Clonorchiasis is related to the development of not only gallstones, but also bile duct stones, and helminthiasis is only associated with the development of gallstones. However, cases of PI are rare in Taiwan, and this requires more international studies to clarify the association between helminthiasis and bile duct stones.

Keywords:

• Clonorchiasis
• helminthiasis
• cholelithiasis
• gallstones
• bile duct stones

Transparency

Declaration of funding

This work was supported by grants from the Ministry of Health and Welfare, Taiwan (MOHW107-TDU-B-212-123004), China Medical University Hospital (DMR-107-192); Academia Sinica Stroke Biosignature Project (BM10701010021); MOST Clinical Trial Consortium for Stroke (MOST 106-2321-B-039-005-); Tseng-Lien Lin Foundation, Taichung, Taiwan; and Katsuzo and Kiyo Aoshima Memorial Funds, Japan. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. No additional external funding received for this study.

Declaration of financial/other relationships

The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Notes

1 Any researcher interested in accessing this dataset can submit an application form to the Ministry of Health and Welfare requesting access. Please contact the staff of MOHW (Email: [email protected]) for further assistance. Taiwan Ministry of Health and Welfare Address: No.488, Sec. 6, Zhongxiao E. Rd., Nangang Dist., Taipei City 115, Taiwan (R.O.C.). Phone: [phone].