Which of the following is NOT a risk factor for cholelithiasis?

Cholelithiasis, or gallstone disease, has several known risk factors that contribute to its development, and understanding these factors clarifies their relationship to the condition.

In the context of this question, having low triglyceride levels is not associated with an increased risk of developing gallstones. In fact, low triglyceride levels are generally considered a marker of good metabolic health and may be linked to a lower risk for a variety of conditions, including those involving gallbladder function.

In contrast, age over forty, female gender, and conditions like cirrhosis are all established risk factors for cholelithiasis. Increasing age allows for greater time for the development of gallstones, while female gender is particularly associated with higher estrogen levels, which can affect gallbladder motility and bile composition. Cirrhosis can lead to abnormalities in bile production and metabolism, further increasing the risk of gallstone formation.

Therefore, the presence of low triglyceride levels distinguishes itself from these other risk factors by not contributing to an elevated risk of cholelithiasis.