COMORBIDITY PATTERNS AND THEIR ASSOCIATION WITH GALLSTONE DISEASE IN THE ELDERLY POPULATION: (A POPULATION-BASED STUDY IN THE FERGANA VALLEY, UZBEKISTAN)

Abstract

Background. Gallstone disease (GSD) is one of the most prevalent disorders of the biliary system and represents an important clinical and public health problem, particularly in older adults. Age-related metabolic changes and the accumulation of chronic diseases may substantially modify the risk, clinical presentation, and course of GSD. The assessment of comorbidity patterns may therefore contribute to the earlier identification of high-risk individuals and the optimization of preventive strategies. Objective. To evaluate the structure of comorbid conditions and their association with gallstone disease among adults aged 60–75 years in the Fergana Valley of Uzbekistan. Materials and Methods. A population-based observational study was conducted among residents aged 60–75 years in Fergana, Uzbekistan. Epidemiological, clinical, laboratory, instrumental, and statistical methods were used. Information on demographic characteristics, metabolic risk factors, cardiovascular diseases, gastrointestinal and hepatobiliary disorders, respiratory diseases, renal disorders, and other chronic conditions was collected from clinical examinations, preventive screening data, and outpatient medical records. Statistical analysis included comparisons between study groups, assessment of categorical variables using the χ² test, calculation of relative risk (RR), 95% confidence intervals (95% CI), and significance levels. Results. The analysis demonstrated a substantial burden of concomitant chronic diseases among older individuals evaluated for gallstone disease. Cardiovascular, gastroenterological, and hepatobiliary comorbidities were among the most frequently identified accompanying conditions. In the comparative analysis, cardiovascular comorbidity was recorded in 17 individuals in the main group and 6 in the control group, gastroenterological comorbidity in 16 and 1, and hepatobiliary comorbidity in 21 and 9 individuals, respectively. Respiratory comorbidity was observed in 10 versus 2 individuals, whereas hematological comorbidity was detected in 2 versus 1. These findings indicate a clustering of chronic metabolic and organ-system disorders in individuals with gallstone disease and suggest an important relationship between multimorbidity and the clinical and epidemiological profile of GSD in older adults. Conclusion. Gallstone disease in adults aged 60–75 years is associated with a considerable burden of comorbid conditions, particularly cardiovascular, gastroenterological, and hepatobiliary disorders. Comprehensive assessment of comorbid conditions should be incorporated into risk stratification and preventive monitoring of older individuals with or at increased risk of gallstone disease.