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Huang X, Hao X, Wang T, Zhang X, Wu P, Shen L, Yang Y, Zhang W, Zhang K. Sex-related association between smoke exposure and gallstones in a US population: a cross-sectional study. BMC Public Health 2025; 25:344. [PMID: 39871261 PMCID: PMC11773891 DOI: 10.1186/s12889-024-21173-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 12/20/2024] [Indexed: 01/29/2025] Open
Abstract
BACKGROUND Cholelithiasis are a condition that creates an economic and medical burden on society, and women are more susceptible to gallbladder stones. However, the effect of smoking on the development of gallstones remains controversial. No studies, to our knowledge, have discussed the association between smoke exposure and gallstones separately in men and women. We evaluated the association between smoking and gallstones in both sexes. METHODS We conducted a cross-sectional analysis using data obtained from the National Health and Nutrition Examination Survey from 2017 to March 2020. The analysis was limited to individuals aged ≥ 20 years with complete information available. Self-reported smoking status, serum cotinine concentration, and self-reported gallstones conditions were combined to analyze the association of gallstones with smoking and cotinine concentration. RESULTS Of the 6,982 participants, a total of 6.2% (212) men and 14.5% (512) women reported having gallstones. Logistic regression analysis showed smoking and high serum cotinine level were risk factors associated with gallstones among women, both in the model 1 (current smoker: odds ratio [OR] = 1.563, 95% confidence interval [CI] = 1.044-2.339, p = 0.032; former smoker: OR = 1.434, 95% CI = 1.116-1.842, p = 0.007; cotinine ≥ 3 ng/mL: OR = 1.800, 95% CI = 1.247-2.596, p = 0.005; and cotinine 0.05-2.99 ng/mL: OR = 1.640, 95% CI = 1.188-2.263, p = 0.005) and model 2 (current smoker: OR = 1.588, 95% CI = 1.015-2.483, p = 0.044; cotinine ≥ 3 ng/mL: OR = 1.825; 95% CI = 1.181-2.821, p = 0.011; and cotinine 0.05-2.99 ng/mL: OR = 1.509, 95% CI = 1.075-2.126, p = 0.022). However, the association was statistically insignificant in men. The subgroup analysis showed the robustness of the association. CONCLUSIONS This study indicates smoking and elevated serum cotinine levels may be risk factors associated with the development of gallstones. Notably, the associations were specifically observed among women. The findings suggest the significance of smoking in the incidence of gallstones, which may potentially provide insights for future research on strategies to prevent gallstones, particularly among women. The validation of these findings necessitates the conduction of large-scale, high-quality prospective studies.
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Affiliation(s)
- Xingyong Huang
- Department of Gastroenterology, Endoscopic Center, Engineering Research Center of Ministry of Education for Minimally Invasive, Gastrointestinal Endoscopic Techniques, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Shenyang, 110004, Liaoning Province, China
| | - Xuanyu Hao
- Department of Gastroenterology, Endoscopic Center, Engineering Research Center of Ministry of Education for Minimally Invasive, Gastrointestinal Endoscopic Techniques, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Shenyang, 110004, Liaoning Province, China
| | - Tingting Wang
- Department of Gastroenterology, Endoscopic Center, Engineering Research Center of Ministry of Education for Minimally Invasive, Gastrointestinal Endoscopic Techniques, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Shenyang, 110004, Liaoning Province, China
| | - Xiaoyue Zhang
- Department of Gastroenterology, Endoscopic Center, Engineering Research Center of Ministry of Education for Minimally Invasive, Gastrointestinal Endoscopic Techniques, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Shenyang, 110004, Liaoning Province, China
| | - Peng Wu
- Department of Gastroenterology, Endoscopic Center, Engineering Research Center of Ministry of Education for Minimally Invasive, Gastrointestinal Endoscopic Techniques, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Shenyang, 110004, Liaoning Province, China
| | - Lufan Shen
- Department of Gastroenterology, Endoscopic Center, Engineering Research Center of Ministry of Education for Minimally Invasive, Gastrointestinal Endoscopic Techniques, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Shenyang, 110004, Liaoning Province, China
| | - Yuanyuan Yang
- Department of Gastroenterology, Endoscopic Center, Engineering Research Center of Ministry of Education for Minimally Invasive, Gastrointestinal Endoscopic Techniques, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Shenyang, 110004, Liaoning Province, China
| | - Wanchuan Zhang
- Department of Gastroenterology, Endoscopic Center, Engineering Research Center of Ministry of Education for Minimally Invasive, Gastrointestinal Endoscopic Techniques, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Shenyang, 110004, Liaoning Province, China.
| | - Kai Zhang
- Department of Gastroenterology, Endoscopic Center, Engineering Research Center of Ministry of Education for Minimally Invasive, Gastrointestinal Endoscopic Techniques, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Shenyang, 110004, Liaoning Province, China.
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Liang F, Qin T, Hao Z, Zheng Y, Zhou Y. Association between circadian syndrome and gallstones in US adult: a cross-sectional study of NHANES 2017-2020. BMC Gastroenterol 2024; 24:442. [PMID: 39614158 DOI: 10.1186/s12876-024-03504-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2024] [Accepted: 11/11/2024] [Indexed: 12/01/2024] Open
Abstract
BACKGROUND The circadian syndrome is linked with chronic diseases such as stroke, kidney stones, and overactive bladder. However, the relationship between circadian syndrome and gallstones is poorly understood. In this study, we aim to investigate whether circadian syndrome is associated with gallstones in a population-based study. METHODS Using data from the National Health and Nutrition Examination Survey (NHANES) database spanning from 2017 to 2020, a cross-sectional study with 2913 participants was performed to assess the relationship between circadian syndrome and gallstones. Univariate and two adjusted multivariate regression models were used to examine the connection between circadian syndrome and gallstones incidence. Smoothed curve fitting using the generalized additive model (GAM) was used to describe the nonlinear relationship. Subgroup analyses were also performed to investigate potential variations in the relationship between circadian syndrome and the risk of developing gallstones. RESULT The findings indicated a positive association of circadian syndrome with gallstones, with model 2 showing a 117% increase in risk (OR = 2.17, 95% CI 1.43, 3.29). In model 3, the incidence of gallstones increased by 76% (OR = 1.76, 95% CI 0.91, 3.43). However, there was no significant relationship between the number of circadian syndrome components and the risk of gallstones. Smooth curve fitting based on the GAM further demonstrated linear relationships between CircS and the risk of gallstones. Subgroup analyses further demonstrated statistically significant associations between circadian syndrome and the prevalence of gallstones among individuals who were non-smokers. CONCLUSION Circadian syndrome was positively associated with the prevalence of gallstones, particularly among non-smoking participants.
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Affiliation(s)
- Fenping Liang
- The First Clinical Medical College, Lanzhou University, Lanzhou, 730000, China
- Department of Gastroenterology, The First Hospital of Lanzhou University, 730000, Lanzhou, China
- Gansu Province Clinical Research Center for Digestive Diseases, The First Hospital of Lanzhou University, 730000, Lanzhou, China
| | - Tianyan Qin
- Follow up Office, Gansu Wuwei Tumor Hospital, 733000, Wuwei, Gansu, China
| | - Zhuang Hao
- The First Clinical Medical College, Lanzhou University, Lanzhou, 730000, China
- Department of Gastroenterology, The First Hospital of Lanzhou University, 730000, Lanzhou, China
- Gansu Province Clinical Research Center for Digestive Diseases, The First Hospital of Lanzhou University, 730000, Lanzhou, China
| | - Ya Zheng
- Department of Gastroenterology, The First Hospital of Lanzhou University, 730000, Lanzhou, China.
- Gansu Province Clinical Research Center for Digestive Diseases, The First Hospital of Lanzhou University, 730000, Lanzhou, China.
| | - Yongning Zhou
- Department of Gastroenterology, The First Hospital of Lanzhou University, 730000, Lanzhou, China.
- Gansu Province Clinical Research Center for Digestive Diseases, The First Hospital of Lanzhou University, 730000, Lanzhou, China.
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Yuan S, Gill D, Giovannucci EL, Larsson SC. Obesity, Type 2 Diabetes, Lifestyle Factors, and Risk of Gallstone Disease: A Mendelian Randomization Investigation. Clin Gastroenterol Hepatol 2022; 20:e529-e537. [PMID: 33418132 DOI: 10.1016/j.cgh.2020.12.034] [Citation(s) in RCA: 71] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 12/22/2020] [Accepted: 12/30/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Obesity, type 2 diabetes, and lifestyle factors (cigarette smoking, alcohol drinking, and coffee consumption) have been associated with the risk of developing gallstone disease in observational studies, but whether these associations are causal is undetermined. We conducted a Mendelian randomization study to assess these associations. METHODS Genetic instruments associated with the exposures at the genome-wide significance (p < 5×10-8) level were selected from corresponding genome-wide association studies (n=224 459 to 1 232 091 individuals). Summary-level data for gallstone disease were obtained from the UK Biobank (10 520 cases and 350 674 non-cases) and FinnGen consortium (11 675 cases and 121 348 non-cases). Univariable and multivariable Mendelian randomization analyses were conducted. Results from UK Biobank and FinnGen were combined using fixed-effects meta-analysis. RESULTS The odds ratios were 1.63 (95% confidence interval (CI), 1.49, 1.79) for one standard deviation (SD) increase in body mass index, 1.81 (95% CI, 1.60, 2.05) for one SD increase in waist circumference, 1.13 (95% CI, 1.09, 1.17) for one unit increase in the log-odds ratio of type 2 diabetes and 1.25 (95% CI, 1.16, 1.34) for one SD increase in prevalence of smoking initiation. The associations for body mass index and type 2 diabetes persisted after mutual adjustment. Genetically predicted coffee consumption was inversely associated with gallstone disease after adjustment for body mass index and smoking (odds ratio per 50% increase 0.44, 95% CI, 0.21, 0.91). There was no association with alcohol consumption. CONCLUSIONS This study supports independent causal roles of obesity, type 2 diabetes, and smoking in gallstone disease.
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Affiliation(s)
- Shuai Yuan
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Dipender Gill
- Department of Biostatistics and Epidemiology, School of Public Health, Imperial College London, London, United Kingdom; Clinical Pharmacology and Therapeutics Section, Institute of Medical and Biomedical Education and Institute for Infection and Immunity, St George's, University of London, London, United Kingdom; Clinical Pharmacology Group, Pharmacy and Medicines Directorate, St George's University Hospitals NHS Foundation Trust, London, United Kingdom; Novo Nordisk Research Centre Oxford, Oxford, United Kingdom
| | - Edward L Giovannucci
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Susanna C Larsson
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Unit of Medical Epidemiology, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
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Kiu KT, Chen HL, Huang MT, Sung CW, Liaw YP, Chang CC, Wang YH, Chen HA. Outcome Analysis of Patients with Gallstone Disease Receiving Cholecystectomy: A Population-Based Cohort Study. Digestion 2017; 95:132-139. [PMID: 28166522 DOI: 10.1159/000455072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 12/13/2016] [Indexed: 02/04/2023]
Abstract
BACKGROUND/AIMS Cholecystectomy is generally performed to treat patients with gallstone disease (GSD) in clinical practice. The present study aimed to investigate whether type 2 diabetes mellitus (T2DM) may influence the overall survival of GSD patients. METHODS The National Health Insurance Research Database, a population-based registry data in Taiwan, was used to identify GSD patients from 2001 to 2008. The risk of cancers and effects of T2DM on the overall survival of GSD patients receiving cholecystectomy were estimated by hazards ratios (HRs) and 95% CIs using the Cox proportional hazard model. RESULTS Among 392,028 eligible GSD patients, 81,971 underwent cholecystectomy, whereas 310,057 did not. After cholecystectomy, the HR for developing cancer was 1.14. The HR for the overall survival was 0.74-fold lower for patients who underwent cholecystectomy than that for patients who did not. GSD patients without T2DM who underwent cholecystectomy (0.78-fold lower risk) had a longer survival, whereas those with T2DM had shorter survival (1.64-fold higher risk without cholecystectomy and 1.13-fold higher risk with cholecystectomy) compared with those without T2DM who did not undergo cholecystectomy. CONCLUSIONS Our major findings suggest that T2DM may worsen the prognosis of GSD patients after cholecystectomy, which provides useful insight into the treatment of T2DM among GSD patients in clinical settings.
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Affiliation(s)
- Kee-Thai Kiu
- Division of General Surgery, Department of Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
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Talseth A, Ness-Jensen E, Edna TH, Hveem K. Risk factors for requiring cholecystectomy for gallstone disease in a prospective population-based cohort study. Br J Surg 2016; 103:1350-7. [PMID: 27220492 PMCID: PMC5089603 DOI: 10.1002/bjs.10205] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Revised: 11/05/2015] [Accepted: 04/04/2016] [Indexed: 11/21/2022]
Abstract
Background The relationship between different lifestyle factors and the risk of needing cholecystectomy for gallstone disease is not clear. This study aimed to assess the association between anthropometric, lifestyle and sociodemographic risk factors and the subsequent risk of requiring cholecystectomy for gallstone disease during long‐term follow‐up in a defined population cohort. Methods Data from a large population‐based cohort study performed from 1995 to 1997 were used (the second Norwegian Nord‐Trøndelag health study, HUNT2). Following HUNT2, from 1998 to 2011, all patients operated on for gallstone disease with cholecystectomy at the two hospitals in the county, Levanger Hospital and Namsos Hospital, were identified. A Cox proportional hazards model was used for multivariable risk analysis. Results The HUNT2 cohort included 65 237 individuals (69·5 per cent response rate), aged 20–99 years. During a median follow‐up of 15·3 (range 0·6–16·4) years, 1162 cholecystectomies were performed. In multivariable analysis, overweight individuals (body mass index (BMI) 25·0–29·9 kg/m2) had a 58 per cent increased risk of cholecystectomy compared with individuals with normal weight (BMI less than 25·0 kg/m2). Obese individuals (BMI 30 kg/m2 or above) had a twofold increased risk. Increasing waist circumference independently increased the risk of cholecystectomy. In women, current hormone replacement therapy (HRT) increased the risk, whereas hard physical activity and higher educational level were associated with reduced risk of cholecystectomy. Conclusion High BMI and waist circumference increased the risk of having cholecystectomy for both sexes. In women, the risk was increased by HRT, and decreased by hard physical activity and higher educational level. Associated with obesity and sedentary lifestyle
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Affiliation(s)
- A Talseth
- Department of Surgery, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway.,HUNT Research Centre, Department of Public Health and General Practice, Norwegian University of Science and Technology, Levanger, Norway
| | - E Ness-Jensen
- HUNT Research Centre, Department of Public Health and General Practice, Norwegian University of Science and Technology, Levanger, Norway.,Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
| | - T-H Edna
- Department of Surgery, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway.,Unit for Applied Clinical Research, Institute of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - K Hveem
- HUNT Research Centre, Department of Public Health and General Practice, Norwegian University of Science and Technology, Levanger, Norway
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Völzke H, Fung G, Ittermann T, Yu S, Baumeister SE, Dörr M, Lieb W, Völker U, Linneberg A, Jørgensen T, Felix SB, Rettig R, Rao B, Kroemer HK. A new, accurate predictive model for incident hypertension. J Hypertens 2015; 31:2142-50; discussion 2150. [PMID: 24077244 DOI: 10.1097/hjh.0b013e328364a16d] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Data mining represents an alternative approach to identify new predictors of multifactorial diseases. This work aimed at building an accurate predictive model for incident hypertension using data mining procedures. METHODS The primary study population consisted of 1605 normotensive individuals aged 20-79 years with 5-year follow-up from the population-based study, that is the Study of Health in Pomerania (SHIP). The initial set was randomly split into a training and a testing set. We used a probabilistic graphical model applying a Bayesian network to create a predictive model for incident hypertension and compared the predictive performance with the established Framingham risk score for hypertension. Finally, the model was validated in 2887 participants from INTER99, a Danish community-based intervention study. RESULTS In the training set of SHIP data, the Bayesian network used a small subset of relevant baseline features including age, mean arterial pressure, rs16998073, serum glucose and urinary albumin concentrations. Furthermore, we detected relevant interactions between age and serum glucose as well as between rs16998073 and urinary albumin concentrations [area under the receiver operating characteristic (AUC 0.76)]. The model was confirmed in the SHIP validation set (AUC 0.78) and externally replicated in INTER99 (AUC 0.77). Compared to the established Framingham risk score for hypertension, the predictive performance of the new model was similar in the SHIP validation set and moderately better in INTER99. CONCLUSION Data mining procedures identified a predictive model for incident hypertension, which included innovative and easy-to-measure variables. The findings promise great applicability in screening settings and clinical practice.
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Affiliation(s)
- Henry Völzke
- aInstitute for Community Medicine, Ernst Moritz Arndt University, Greifswald, Germany bSiemens Healthcare, Malvern, Pennsylvania, USA cClinic of Internal Medicine B, Ernst Moritz Arndt University, Greifswald dInstitute of Epidemiology, Christian Albrechts University, Kiel eInterfaculty Institute of Functional Genomics, Ernst Moritz Arndt University, Greifswald, Germany fResearch Centre for Prevention and Health, Glostrup University Hospital, Glostrup gFaculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark hInstitute of Physiology, University Medicine, Ernst Moritz Arndt University, Greifswald iUniversity Medical Center, Göttingen, Germany *Henry Völzke and Glenn Fung contributed equally to the writing of this article
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Chen L, Peng YT, Chen FL, Tung TH. Epidemiology, management, and economic evaluation of screening of gallstone disease among type 2 diabetics: A systematic review. World J Clin Cases 2015; 3:599-606. [PMID: 26244151 PMCID: PMC4517334 DOI: 10.12998/wjcc.v3.i7.599] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Revised: 01/30/2015] [Accepted: 04/14/2015] [Indexed: 02/05/2023] Open
Abstract
The knowledge of gallstone disease (GSD) is crucial to manage this condition when organizing screening and preventive strategies and identifying the appropriated clinical therapies. Although cholecystectomy still be the gold standard treatment for patients with symptomatic GSD, expectant management could be viewed as a valid therapeutic method for this disorder. If early treatment of GSD decreases the morbidity or avoids further cholecystectomy, it may save clinical care costs in later disease periods sufficiently to offset the screening and early treatment costs. In addition, whether routine screening for GSD is worthwhile depends on whether patients are willing to pay the ultrasonography screening cost that would reduce the risk of cholecystectomy. In this review we discuss the epidemiology, management, and economic evaluation of screening of GSD among type 2 diabetics.
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Kwak MS, Kim D, Chung GE, Kim W, Kim YJ, Yoon JH. Cholecystectomy is independently associated with nonalcoholic fatty liver disease in an Asian population. World J Gastroenterol 2015; 21:6287-6295. [PMID: 26034364 PMCID: PMC4445106 DOI: 10.3748/wjg.v21.i20.6287] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Revised: 02/09/2015] [Accepted: 04/03/2015] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the relationship between gallstone disease and nonalcoholic fatty liver disease (NAFLD) in a large Asian population.
METHODS: A cross-sectional study including 17612 subjects recruited from general health check-ups at the Seoul National University Hospital, Healthcare System Gangnam Center between January 2010 and December 2010 was conducted. NAFLD and gallstone disease were diagnosed based on typical ultrasonographic findings. Subjects who were positive for hepatitis B or C, or who had a history of heavy alcohol consumption (> 30 g/d for men and > 20 g/d for women) or another type of hepatitis were excluded. Gallstone disease was defined as either the presence of gallstones or previous cholecystectomy, and these two entities (gallstones and cholecystectomy) were analyzed separately. Clinical parameters including body mass index, waist circumference, hypertension, diabetes, smoking status, and regular physical activity were reviewed. Laboratory parameters, including serum levels of gamma-glutamyl transpeptidase, alanine aminotransferase, aspartate aminotransferase, fasting glucose, fasting insulin, total cholesterol, triglycerides, and high-density lipoprotein, were also reviewed.
RESULTS: The mean age of the subjects was 48.5 ± 11.3 years, and 49.3% were male. Approximately 30.3% and 6.1% of the subjects had NAFLD and gallstone disease, respectively. The prevalence of gallstone disease (8.3% vs 5.1%, P < 0.001), including both the presence of gallstones (5.5% vs 3.4%, P < 0.001) and a history of cholecystectomy (2.8% vs 1.7%, P < 0.001), was significantly increased in the NAFLD group. In the same manner, the prevalence of NAFLD increased with the presence of gallstone disease (41.3% vs 29.6%, P < 0.001). Multivariate regression analysis showed that cholecystectomy was associated with NAFLD (OR = 1.35, 95%CI: 1.03-1.77, P = 0.028). However, gallstones were not associated with NAFLD (OR = 1.15, 95%CI: 0.95-1.39, P = 0.153). The independent association between cholecystectomy and NAFLD was still significant after additional adjustment for insulin resistance (OR = 1.45, 95%CI: 1.01-2.08, P = 0.045).
CONCLUSION: This study shows that cholecystectomy, but not gallstones, is independently associated with NAFLD after adjustment for metabolic risk factors. These data suggest that cholecystectomy may be an independent risk factor for NAFLD.
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Bang CS, Yoon JH, Kim YJ, Kim JB, Baik GH, Suk KT, Kim YS, Kim DJ. Clinical impact of body mass index on bactibilia and bacteremia. BMC Gastroenterol 2014; 14:104. [PMID: 24902609 PMCID: PMC4073193 DOI: 10.1186/1471-230x-14-104] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Accepted: 06/02/2014] [Indexed: 01/07/2023] Open
Abstract
Background The aim of this study was to evaluate the association between obesity and infected bile or bacteremia in patients with acute calculous cholecystitis. Methods Authors analyzed the medical records of 139 patients who had undergone cholecystectomy for the treatment of acute calculous cholecystitis from January 2007 to June 2013 in a single teaching hospital. Association of body mass index (BMI) with bactibilia and bacteremia was assessed using univariate and multivariate analysis. Clinical findings and biliary infection related data were recorded for the following variables: gender, age, alcohol and smoking history, the results of blood and bile cultures, cholesterolosis, diabetes, hypertension, and duration of the hospital stay. Results The microbial culture rate of bactibilia and bacteremia were 50.4% and 21.6%, respectively. In the univariate analysis, bacteremia was associated with bactibilia (OR: 4.33, p = 0.002). In the multivariate analysis for the risk factors of bactibilia, BMI and bacteremia were related with bactibilia (OR: 0.59, 95% CI: 0.42-0.84, p = 0.003) (OR: 3.32, 95% CI: 1.22-9, p = 0.02). In the multivariate analysis for the risk factors of bacteremia, BMI, bactibilia and age were related with bacteremia (OR: 0.76, 95% CI: 0.59-0.99, p = 0.04) (OR: 3.46, 95% CI: 1.27-9.45, p = 0.02) (OR: 1.05, 95% CI: 1.01-1.09, p = 0.02). Conclusion In this retrospective study, BMI was inversely correlated with bacteremia or bactibilia, which means obese or overweight patients are less likely to be associated with bacteremia or bactibilia in patients with acute calculous cholecystitis.
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Affiliation(s)
| | - Jai Hoon Yoon
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, South Korea.
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Talseth A, Lydersen S, Skjedlestad F, Hveem K, Edna TH. Trends in cholecystectomy rates in a defined population during and after the period of transition from open to laparoscopic surgery. Scand J Gastroenterol 2014; 49:92-8. [PMID: 24354967 DOI: 10.3109/00365521.2013.853828] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To evaluate cholecystectomy rates in a Norwegian county during the transition time from open to laparoscopic surgery, with focus on the incident rate of laparoscopic operations, sex differences, age at operation, and indications for cholecystectomy. MATERIAL AND METHODS All 2615 patients living in North Trondelag County and operated with cholecystectomy for benign biliary disease between 1990 and 2011 were identified. Poisson regression was used to analyze factors associated with cholecystectomy incidence rate ratios (IRRs). RESULTS The proportion of completed laparoscopic cholecystectomies was 8% in 1992, 50% in 1994, 94% in 2003 and 99% in 2011. The incidence of cholecystectomy increased from 6.2 per 10 000 person-years in 1990-1992, 8.0 in 1993-1997, to 10.0 in 1998-2003 and remained at this level with a rate of 10.7 during 2004-2011. Adjusting for age at each year of surgery the IRR for females compared with males was 2.3(2.1-2.5) p < 0.001. The median age at operation was 60.2 years (13-90) in males, 50.1 years (12-93) in females p < 0.001. The median age diminished by 5 years in both males and females. A conversion from laparoscopic to open surgery decreased significantly by calendar year of surgery, increased with age of the patient, and was less often in surgery for gallstone colic than for other indications. CONCLUSIONS During the introduction of laparoscopic surgery, the rates of cholecystectomy increased and remained stable at a higher level during the later years of the study. The rate of completed laparoscopic operations increased from 8% in 1992 to 99% in 2011.
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Affiliation(s)
- Arne Talseth
- Department of Surgery, Levanger Hospital, Nord-Trøndelag Health Trust , Levanger , Norway
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von Kampen O, Buch S, Nothnagel M, Azocar L, Molina H, Brosch M, Erhart W, von Schönfels W, Egberts J, Seeger M, Arlt A, Balschun T, Franke A, Lerch MM, Mayerle J, Kratzer W, Boehm BO, Huse K, Schniewind B, Tiemann K, Jiang ZY, Han TQ, Mittal B, Srivastava A, Fenger M, Jørgensen T, Schirin-Sokhan R, Tönjes A, Wittenburg H, Stumvoll M, Kalthoff H, Lammert F, Tepel J, Puschel K, Becker T, Schreiber S, Platzer M, Völzke H, Krawczak M, Miquel JF, Schafmayer C, Hampe J. Genetic and functional identification of the likely causative variant for cholesterol gallstone disease at the ABCG5/8 lithogenic locus. Hepatology 2013; 57:2407-17. [PMID: 22898925 DOI: 10.1002/hep.26009] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2012] [Accepted: 07/23/2012] [Indexed: 12/13/2022]
Abstract
UNLABELLED The sterolin locus (ABCG5/ABCG8) confers susceptibility for cholesterol gallstone disease in humans. Both the responsible variant and the molecular mechanism causing an increased incidence of gallstones in these patients have as yet not been identified. Genetic mapping utilized patient samples from Germany (2,808 cases, 2,089 controls), Chile (680 cases, 442 controls), Denmark (366 cases, 766 controls), India (247 cases, 224 controls), and China (280 cases, 244 controls). Analysis of allelic imbalance in complementary DNA (cDNA) samples from human liver (n = 22) was performed using pyrosequencing. Transiently transfected HEK293 cells were used for [(3) H]-cholesterol export assays, analysis of protein expression, and localization of allelic constructs. Through fine mapping in German and Chilean samples, an ∼250 kB disease-associated interval could be defined for this locus. Lack of allelic imbalance or allelic splicing of the ABCG5 and ABCG8 transcripts in human liver limited the search to coding single nucleotide polymorphisms. Subsequent mutation detection and genotyping yielded two disease-associated variants: ABCG5-R50C (P = 4.94 × 10(-9) ) and ABCG8-D19H (P = 1.74 × 10(-10) ) in high pairwise linkage disequilibrium (r(2) = 0.95). [(3) H]-cholesterol export assays of allelic constructs harboring these genetic candidate variants demonstrated increased transport activity (3.2-fold, P = 0.003) only for the ABCG8-19H variant, which was also superior in nested logistic regression models in German (P = 0.018), Chilean (P = 0.030), and Chinese (P = 0.040) patient samples. CONCLUSION This variant thus provides a molecular basis for biliary cholesterol hypersecretion as the mechanism for cholesterol gallstone formation, thereby drawing a link between "postgenomic" and "pregenomic" pathophysiological knowledge about this common complex disorder. (HEPATOLOGY 2012).
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Affiliation(s)
- Oliver von Kampen
- Department of Internal Medicine I, Hospital Schleswig-Holstein, Kiel, Germany
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Racine A, Bijon A, Fournier A, Mesrine S, Clavel-Chapelon F, Carbonnel F, Boutron-Ruault MC. Menopausal hormone therapy and risk of cholecystectomy: a prospective study based on the French E3N cohort. CMAJ 2013; 185:555-61. [PMID: 23509128 DOI: 10.1503/cmaj.121490] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Studies in the United States and the United Kingdom have reported an increased risk of cholecystectomy among women exposed to menopausal hormone therapy, but with substantial heterogeneity between types of hormone treatments. We evaluated the risk of cholecystectomy associated with different regimens of menopausal hormone therapy in a large prospective cohort study. METHODS Between 1992 and 2008, 70 928 menopausal women from the French E3N study cohort were sent questionnaires assessing their use of menopausal hormone therapy, medical history and lifestyle characteristics. The primary outcome was cholecystectomy. We analyzed the risk of cholecystectomy associated with use of menopausal hormone therapy using Cox proportional models, with age as time-scale. RESULTS During follow-up, 45 984 (64.8%) of the participants were exposed to menopausal hormone therapy, and 2819 cholecystectomies were recorded. The use of menopausal hormone therapy was associated with an increased risk of cholecystectomy (adjusted hazard ratio [HR] 1.10, 95% confidence interval [CI] 1.01-1.20) compared with women who were not exposed to menopausal hormone therapy. The association was restricted to unopposed oral estrogen therapy (adjusted HR 1.38, 95% CI 1.14-1.67). Over 5 years, about 1 cholecystectomy in excess would be expected in every 150 women using oral estrogen therapy without progestogens, compared with women not exposed to menopausal hormone therapy. INTERPRETATION The risk of cholecystectomy was increased among women exposed to oral estrogen menopausal hormone therapy, especially oral regimens without a progestagen. Complicated gallstone disease should be added to the list of potential adverse events to be considered when balancing the benefits and risks associated with menopausal hormone therapy.
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Affiliation(s)
- Antoine Racine
- Institut national de la santé et de la recherche médicale (INSERM), the Centre for Research in Epidemiology and Population Health and Université Paris Sud, Villejuif, France.
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Jeong SU, Lee SK. [Obesity and gallbladder diseases]. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2012; 59:27-34. [PMID: 22289951 DOI: 10.4166/kjg.2012.59.1.27] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Obesity is an important health problem in the world and related to many critical diseases, such as diabetes, cardiovascular disease, and metabolic syndrome. Obesity leads to fat infiltration of multiple organs and infiltrated adipose tissue produces many cytokines resulting in the dysfunction of organs such as the gallbladder. In the biliary diseases, obesity and overweight have been known as a major risk factor for gallstones. According to current studies, obesity, insulin resistance, hyperinsulinemia, and metabolic syndrome are related to various gallbladder diseases including gallbladder stones, cholecystitis, gallbladder polyps, and gallbladder cancers. We reviewed further literature on the obesity and gallbladder diseases, in aspects of epidemiology, mechanism, pathology and prevention.
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Affiliation(s)
- Seung Uk Jeong
- Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
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Liu CM, Hsu CT, Li CY, Chen CC, Liu ML, Liu JH. A population-based cohort study of symptomatic gallstone disease in diabetic patients. World J Gastroenterol 2012; 18:1652-9. [PMID: 22529695 PMCID: PMC3325532 DOI: 10.3748/wjg.v18.i14.1652] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2011] [Revised: 11/08/2011] [Accepted: 12/16/2011] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the prevalence of gallstone disease (GSD) and to evaluate the risk of symptomatic GSD among diabetic patients.
METHODS: The study was conducted by analyzing the National Health Research Institutes (NHRI) dataset of ambulatory care patients, inpatient claims, and the updated registry of beneficiaries from 2000 to 2008. A total of 615 532 diabetic patients without a prior history of hospital treatment or ambulatory care visits for symptomatic GSD were identified in the year 2000. Age- and gender-matched control individuals free from both GSD and diabetes from 1997 to 1999 were randomly selected from the NHIR database (n = 614 871). The incidence densities of symptomatic GSD were estimated according to the subjects’ diabetic status. The distributions of age, gender, occupation, income, and residential area urbanization were compared between diabetic patients and control subjects using Cox proportion hazards models. Differences between the rates of selected comorbidities were also assessed in the two groups.
RESULTS: Overall, 60 734 diabetic patients and 48 116 control patients developed symptomatic GSD and underwent operations, resulting in cumulative operation rates of 9.87% and 7.83%, respectively. The age and gender distributions of both groups were similar, with a mean age of 60 years and a predominance of females. The diabetic group had a significantly higher prevalence of all comorbidities of interest. A higher incidence of symptomatic GSD was observed in females than in males in both groups. In the control group, females under the age of 64 had a significantly higher incidence of GSD than the corresponding males, but this difference was reduced with increasing age. The cumulative incidences of operations for symptomatic GSD in the diabetic and control groups were 13.06 and 9.52 cases per 1000 person-years, respectively. Diabetic men exhibited a higher incidence of operations for symptomatic GSD than did their counterparts in the control group (12.35 vs 8.75 cases per 1000 person-years).
CONCLUSION: The association of diabetes with increased symptomatic GSD may provide insight to the treatment or management of diabetes in clinical settings.
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Timmer A, Behrens R, Buderus S, Findeisen A, Hauer A, Keller KM, Kliemann G, Lang T, Lohr W, Rzehak P, Koletzko S. Childhood onset inflammatory bowel disease: predictors of delayed diagnosis from the CEDATA German-language pediatric inflammatory bowel disease registry. J Pediatr 2011; 158:467-473.e2. [PMID: 21051046 DOI: 10.1016/j.jpeds.2010.09.014] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2010] [Revised: 06/29/2010] [Accepted: 09/01/2010] [Indexed: 01/16/2023]
Abstract
OBJECTIVES To examine predictors of delayed diagnosis of inflammatory bowel disease in children and adolescents. STUDY DESIGN A total of 2,436 patients (age 0-18 years) with Crohn's disease, ulcerative colitis, or unclassified colitis were included from 53 pediatric gastroenterologists. Predictors were examined with the proportional hazards model, presented as hazard ratios (HR) with 95% confidence intervals. HR < 1.0 represent factors associated with late diagnosis. RESULTS Median time to diagnosis was 4 (2-8) months. Crohn's disease (HR 0.62; 0.56-0.68), and within Crohn's disease, ileal disease (HR 0.77, 95% confidence interval 0.67 to 0.89) were associated with delayed diagnosis. Chances for early diagnosis increased with increasing age (HR 1.07 per year of age; 1.06 to 1.08). There was also an effect by center (HR 0.63, 0.52 to 0.67), but not by sex or country (Austria vs Germany). Growth failure was more common in those cases with delayed diagnosis. CONCLUSIONS There is still concern about delays in the diagnosis of inflammatory bowel disease in the very young and in children with small bowel disease. Inequalities of care by region require further investigation.
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Affiliation(s)
- Antje Timmer
- HelmholtzZentrum München, German Research Centre for Health and Environment, Department of Epidemiology, Neuherberg, Germany
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Lack of association between insulin-like growth factor-1 or insulin-like growth factor-binding protein-3 and left ventricular hypertrophy: results of the Study of Health in Pomerania. J Hypertens 2010; 28:856-64. [DOI: 10.1097/hjh.0b013e328336274a] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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The national mortality burden and significant factors associated with open and laparoscopic cholecystectomy: 1997-2006. J Gastrointest Surg 2009; 13:2292-301. [PMID: 19727976 DOI: 10.1007/s11605-009-0988-2] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2009] [Accepted: 08/04/2009] [Indexed: 01/31/2023]
Abstract
INTRODUCTION This study aims to determine the mortality rate and significant factors associated with laparoscopic (LC) and open cholecystectomies (OC) over a 10-year period. METHODS Using the Nationwide Inpatient Sample, we analyzed data for both LC and OC between 1997 and 2006. Cholecystectomies performed as part of another primary procedure were excluded. Using procedure-specific codes, we calculated annual national volumes for both open and laparoscopic cholecystectomies for the time period under review and the associated in-hospital mortality following both of these procedures. Using logistic regression modeling, we then analyzed selected patient and institutional characteristics to determine if a significant association existed between these factors and in-hospital mortality. RESULTS There was a 16% increase in the volume of LC and a corresponding decrease in open procedures over the 10 years under review. In 2006, 12% of cholecystectomies were still performed using an open approach and the associated mortality remained significantly higher than that seen with LC. Overall, after adjusting for patient and hospital characteristics, the mortality for OC was higher than that for LC (OR 4.57; 95% CI, 4.37-4.79, p < 0.001). Age (>60 years), male gender, non-elective admission, admission source, and a primary diagnosis other than cholelithiasis were all independently associated with increased mortality. The average mortality rate associated with conversion from LC to OC was found to be 0.7%. CONCLUSIONS These data indicate an increase in the proportion LCs performed over the years under study with a decrease in the proportion of OCs. However, OCs remain associated with a significant mortality burden when compared with the laparoscopic approach.
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