Sex and ethnic/racial-specific risk factors for gallbladder disease.
Sex and ethnic/racial-specific risk factors for gallbladder disease.
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DOI：
10.1186/s12876-017-0678-6
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发表时间：
2017-12-08
影响因子：
2.4
通讯作者：
Setiawan VW
中科院分区：
文献类型：
--
作者：
Figueiredo JC;Haiman C;Porcel J;Buxbaum J;Stram D;Tambe N;Cozen W;Wilkens L;Le Marchand L;Setiawan VW
胆囊疾病（GBD）是一种高度流行的疾病;然而，对性别和种族/人种的风险因素的潜在差异知之甚少。我们的目的是评估饮食，生殖和肥胖相关因素和GBD在多民族人群。我们对多种族队列研究进行了前瞻性分析，这些研究对象自认为是非西班牙裔白色人（n = 32，103）、非裔美国人（n = 30，209）、日本人（n = 35，987）、夏威夷原住民（n = 6942）和拉丁美洲人（n = 39，168）。使用医疗保险和加州医院出院文件（1993-2012年）和自我完成的问卷确定GBD病例。我们使用基线问卷中的暴露信息来识别感兴趣的暴露。使用校正混杂因素的考克斯模型，通过风险比和95%置信区间估计相关性。经过中位10.7年的随访，有13，437例GBD病例。BMI超过25 kg/m2，糖尿病，过去和现在吸烟，红肉消费，饱和脂肪和胆固醇是种族/种族人群的重要风险因素（p趋势< 0.01）。保护因素包括剧烈的体力活动，饮酒，水果，蔬菜和富含膳食纤维的食物（p趋势< 0.01）。碳水化合物仅在南美洲/墨西哥出生的妇女和拉丁美洲人中与GBD风险呈负相关（p趋势< 0.003）。产次是女性中的一个重要风险因素;绝经后使用激素仅与白色女性中的风险增加相关（仅雌激素：HR = 1.24; 95% CI = 1.07-1.43和雌激素+孕激素：HR = 1.23; 95% CI = 1.06-1.42）。总体而言，饮食，生殖和肥胖相关因素是影响不同种族/种族男性和女性的GBD的强风险因素;然而，一些风险因素在女性和某些种族群体中似乎更强。本文的在线版本（doi：10.1186/s12876-017-0678-6）包含补充材料，可供授权用户使用。
Gallbladder disease (GBD) is a highly prevalent condition; however, little is known about potential differences in risk factors by sex and ethnicity/race. Our aim was to evaluate dietary, reproductive and obesity-related factors and GBD in multiethnic populations. We performed a prospective analysis from the Multiethnic Cohort study who self-identified as non-Hispanic White (n = 32,103), African American (n = 30,209), Japanese (n = 35,987), Native Hawaiian (n = 6942) and Latino (n = 39,168). GBD cases were identified using Medicare and California hospital discharge files (1993–2012) and self-completed questionnaires. We used exposure information on the baseline questionnaire to identify exposures of interest. Associations were estimated by hazard ratios and 95% confidence intervals using Cox models adjusted for confounders. After a median 10.7 years of follow-up, there were 13,437 GBD cases. BMI over 25 kg/m2, diabetes, past and current smoking, red meat consumption, saturated fat and cholesterol were significant risk factors across ethnic/racial populations (p-trends < 0.01). Protective factors included vigorous physical activity, alcohol use, fruits, vegetables and foods rich in dietary fiber (p-trends < 0.01). Carbohydrates were inversely associated with GBD risk only among women and Latinos born in South America/Mexico (p-trend < 0.003). Parity was a significant risk factor among women; post-menopausal hormones use was only associated with an increased risk among White women (estrogen-only: HR = 1.24; 95% CI = 1.07–1.43 and estrogen + progesterone: HR = 1.23; 95% CI = 1.06–1.42). Overall, dietary, reproductive and obesity-related factors are strong risk factors for GBD affecting men and women of different ethnicities/races; however some risk factors appear stronger in women and certain ethnic groups. The online version of this article (doi: 10.1186/s12876-017-0678-6) contains supplementary material, which is available to authorized users.
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