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[17] [18] Additional risk factors include: Female sex and pregnancy history : Women, particularly those who have been pregnant, have higher baseline gallstone risk Age over 40 years : Gallbladder disease incidence increases with age Obesity : Higher BMI correlates with increased gallstone prevalence Diabetes : Type 2 diabetes itself is associated with gallbladder dysfunction Rapid weight cycling : History of repeated weight loss and regain Certain ethnicities : Native American and Hispanic populations have higher gallstone rates [23] [24] Family history : Genetic predisposition to gallbladder disease Estrogen therapy : May increase cholesterol saturation in bile Patients with multiple risk factors should engage in thorough discussion with their healthcare provider about symptom awareness

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Complementing randomized trial evidence, extensive real-world observational data from large healthcare databases consistently demonstrate associations between GLP-1 receptor agonist utilization and decreased risks of MALOs involving cirrhosis, hepatic decompensation, HCC, and death from hepatic causes in patients with MASLD and type 2 diabetes