WEIGHT, DIET, AND THE RISK OF SYMPTOMATIC GALLSTONES IN MIDDLE-AGED WOMEN
WEIGHT, DIET, AND THE RISK OF SYMPTOMATIC GALLSTONES IN MIDDLE-AGED WOMEN
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DOI：
10.1056/nejm198908313210902
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发表时间：
1989-08-31
影响因子：
158.5
通讯作者：
WILLETT, WC
中科院分区：
文献类型：
--
作者：
MACLURE, KM;HAYES, KC;WILLETT, WC
为了评估症状性胆结石的危险因素，在1980年完成关于食物和酒精摄入量的详细问卷调查后，对护士健康研究队列中的88，837名妇女（年龄范围，34至59岁）进行了为期四年的随访。在四年的追踪期间，共有433例胆囊切除术和179例新症状的未切除的胆结石，经超音波检查或X线片诊断。与相对体重小于20 kg/m2的女性相比，相对体重的克托莱指数（以千克为单位的体重除以以米为单位的身高的平方）大于32 kg/m2的非常肥胖女性的年龄调整相对风险为6.0（95%置信区间为4.0 ~ 9.0）。对于轻度超重的女性（相对体重，每平方米24至24.9公斤），相对风险为1.7（95%置信区间，1.1至2.7）。总的来说，我们观察到相对体重和胆结石风险之间大致呈线性关系。在相对体重低于每平方米25公斤的59,306名妇女中，（>8200 J/天），与低能量摄入相比（< 4730 J/天），与症状性胆结石的发病率增加有关（相对危险度，2.1; 95%置信区间，1.4 - 3.3），与戒酒相比，每天至少5次饮酒与发病率降低有关。（相对风险，0.6; 95%置信区间，0.4至0.8）。在对相对权重进行调整后，胎次似乎不是一个重要的风险因素。这些数据支持肥胖和有症状的胆结石之间的强相关性，并表明即使是中度超重也可能增加风险。
To assess the risk factors for symptomatic gallstones, 88,837 women in the Nurses'' Health Study cohort (age range, 34 to 59 years) were followed for four years after completing a detailed questionnaire about food and alcohol intake in 1980. A total of 433 cholecystectomies and 179 cases of newly symptomatic, unremoved gallstones, diagnosed by ultrasonographic examination or x-ray films, were reported during the four-year follow-up. The age-adjusted relative risk for very obese women, who had a Quetelet index of relative weight (weight in kilograms divided by the square of the height in meters) of more than 32 kg per square meter, was 6.0 (95 percent confidence interval, 4.0 to 9.0), as compared with women whose relative weight was less than 20 kg per square meter. For slightly overweight women (relative weight, 24 to 24.9 kg per square meter), the relative risk was 1.7 (95 percent confidence interval, 1.1 to 2.7). Overall, we observed a roughly linear relation between relative weight and the risk of gallstones. Among the 59,306 women whose relative weight was less than 25 kg per square meter, a high energy intake (>8200 J per day), as compared with a low energy intake (< 4730 J per day), was associated with an increased incidence of symptomatic gallstones (relative risk, 2.1; 95 percent confidence interval, 1.4 to 3.3), and an alcohol intake of a least 5 per day was associated with a decreased incidence as compared with abstention (relative risk, 0.6; 95 percent confidence interval, 0.4 to 0.8). Parity did not appear to be an important risk factor after an adjustment was made for relative weight. These data support a strong association between obesity and symptomatic gallstones and suggest that even moderate overweight may increase the risk.