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)
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)
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DOI：
10.1097/meg.0b013e3283477cc9
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发表时间：
2011-08-01
影响因子：
2.1
通讯作者：
Hart, Andrew R.
中科院分区：
文献类型：
--
作者：
Banim, Paul J. R.;Luben, Robert N.;Hart, Andrew R.
目的肥胖和饮酒影响胆结石的发生发展。这项研究的目的是精确地量化这些风险，并调查是否病因机制可能涉及血脂，首次使用欧洲前瞻性队列study.Methods欧洲前瞻性调查癌症诺福克，招募了25 639名男性和女性，年龄在40至74岁，1993年和1997年之间。在登记时，记录体重、身高和酒精摄入量，并采集非空腹血液样本测量血清甘油三酯、胆固醇、高密度脂蛋白和低密度脂蛋白。对该队列进行了14年的症状性胆结石监测。考克斯回归估计性别特异性风险比（HRs）的症状性胆结石调整为covariates.Results症状性胆结石296人（67.9%的妇女）。对于每增加一个BMI单位，男性的HR为1.08 [95%置信区间（CI）= 1.02-1.14];女性的HR为1.08（95% CI=1.06-1.11）。每周饮酒每单位可使男性风险降低3%（HR = 0.97，95%CI =0.95-0.99），对女性无影响。血清甘油三酯增加男性（最高vs.最低四分之一HR = 2.02，95% CI=1.03-3.98）和女性（HR = 2.43，95% CI=1.52-3.90）的风险。高密度脂蛋白升高与男性（最高与最低四分之一HR = 0.22，95% CI=0.09-0.52）和女性（HR = 0.55，95% CI=0.36-0.85）的风险降低相关。结论肥胖和酒精可能通过影响血脂水平影响胆结石形成。减少肥胖可以预防人群中的胆结石，因为38%的胆结石病例与BMI超过25有关。Eur J Gastroenterol Hepatol 23：733-740（C）2011 Wolters Kluwer Health|利平科特威廉姆斯&威尔金斯。
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 prospective 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 sex-specific 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. Eur J Gastroenterol Hepatol 23: 733-740 (C) 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins.