TY - JOUR
T1 - The aetiology of symptomatic gallstones quantification of the effects of obesity, alcohol and serum lipids on risk. Epidemiological and biomarker data from a UK prospective cohort study (EPIC-Norfolk)
AU - Banim, Paul J. R.
AU - Luben, Robert N.
AU - Bulluck, Heerajnarain
AU - Sharp, Stephen J.
AU - Wareham, Nicholas J.
AU - Khaw, Kay-Tee
AU - Hart, Andrew R.
PY - 2011
Y1 - 2011
N2 - Objective
The development of gallstones is influenced by obesity and alcohol. This study aimed to precisely quantify these risks and investigate whether the aetiological
mechanism may involve serum lipids, for the first time using a European rospective cohort study.
Methods
The European Prospective Investigation into Cancer-Norfolk, recruited 25 639 men and women, aged 40 to 74 years, between 1993 and 1997. At enrolment weight,
height and alcohol intake were recorded and nonfasting blood samples taken to measure serum triglycerides, cholesterol, high-density lipoproteins and low-density lipoproteins. The cohort was monitored for 14 years for symptomatic gallstones. Cox regression estimated sexspecific hazard ratios (HRs) for symptomatic gallstones adjusted for covariates.
Results
Symptomatic gallstones developed in 296 people (67.9% women). For each additional unit of BMI, the HR in men was 1.08 [95% confidence interval (CI) = 1.02–1.14]; in women the HR was 1.08 (95% CI= 1.06–1.11). Every unit of
alcohol consumed per week decreased risk in men by 3% (HR = 0.97, 95% CI= 0.95–0.99) with no effect in women. Serum triglycerides increased risk in men (highest vs. lowest quarter HR= 2.02, 95% CI= 1.03–3.98) and women (HR =2.43, 95% CI =1.52–3.90). Increased high-density lipoprotein was associated with a decreased risk in men (highest vs. lowest quarter HR = 0.22, 95% CI= 0.09–0.52)
and women (HR = 0.55, 95% CI =0.36–0.85). No effects were found for serum cholesterol and low-density lipoprotein.
Conclusion
Obesity and alcohol influence gallstone formation, possibly in part through their effects on serum lipids. Reducing obesity may prevent gallstones in the population, as 38% of incident cases of gallstones were associated with a BMI of more than 25.
AB - Objective
The development of gallstones is influenced by obesity and alcohol. This study aimed to precisely quantify these risks and investigate whether the aetiological
mechanism may involve serum lipids, for the first time using a European rospective cohort study.
Methods
The European Prospective Investigation into Cancer-Norfolk, recruited 25 639 men and women, aged 40 to 74 years, between 1993 and 1997. At enrolment weight,
height and alcohol intake were recorded and nonfasting blood samples taken to measure serum triglycerides, cholesterol, high-density lipoproteins and low-density lipoproteins. The cohort was monitored for 14 years for symptomatic gallstones. Cox regression estimated sexspecific hazard ratios (HRs) for symptomatic gallstones adjusted for covariates.
Results
Symptomatic gallstones developed in 296 people (67.9% women). For each additional unit of BMI, the HR in men was 1.08 [95% confidence interval (CI) = 1.02–1.14]; in women the HR was 1.08 (95% CI= 1.06–1.11). Every unit of
alcohol consumed per week decreased risk in men by 3% (HR = 0.97, 95% CI= 0.95–0.99) with no effect in women. Serum triglycerides increased risk in men (highest vs. lowest quarter HR= 2.02, 95% CI= 1.03–3.98) and women (HR =2.43, 95% CI =1.52–3.90). Increased high-density lipoprotein was associated with a decreased risk in men (highest vs. lowest quarter HR = 0.22, 95% CI= 0.09–0.52)
and women (HR = 0.55, 95% CI =0.36–0.85). No effects were found for serum cholesterol and low-density lipoprotein.
Conclusion
Obesity and alcohol influence gallstone formation, possibly in part through their effects on serum lipids. Reducing obesity may prevent gallstones in the population, as 38% of incident cases of gallstones were associated with a BMI of more than 25.
U2 - 10.1097/MEG.0b013e3283477cc9
DO - 10.1097/MEG.0b013e3283477cc9
M3 - Article
SN - 0954-691X
VL - 23
SP - 733
EP - 740
JO - European Journal of Gastroenterology & Hepatology
JF - European Journal of Gastroenterology & Hepatology
IS - 8
ER -