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胆石病与死亡率:一项队列研究。

Gallstone disease and mortality: a cohort study.

机构信息

Digestive Disease Center, Bispebjerg University Hospital, Bispebjerg Bakke 23, 2400, Copenhagen, Denmark.

Research Centre for Prevention and Health, Centre for Health, Capital Region of Denmark, Glostrup, Denmark.

出版信息

Int J Public Health. 2017 Apr;62(3):353-360. doi: 10.1007/s00038-016-0916-7. Epub 2016 Nov 4.

Abstract

OBJECTIVES

The objective of this cohort study was to determine whether subjects with gallstone disease identified by screening of a general population had increased overall mortality when compared to gallstone-free participants and to explore causes of death.

METHODS

The study population (N = 5928) was examined 1982-1992 and included an abdominal ultrasound examination to assess gallstone status, a physical examination, blood samples, and a questionnaire about medical history. Participants were followed up through national registers until 2015. Multiple adjusted Cox regression models were built.

RESULTS

Gallstone disease was present in 10%. Mortality was 46% during median 24.7 years of follow-up with 1% lost. Overall mortality and death from cardiovascular diseases were significantly associated to gallstone disease. Death from unknown causes was significantly associated to gallstone disease and death from cancer and gastrointestinal disease was not associated. No differences in mortality for ultrasound-proven gallstones or cholecystectomy were identified.

CONCLUSIONS

Gallstone disease is associated with increased overall mortality and to death from cardiovascular disease. Gallstones may be considered a possible cardiometabolic risk factor. Other unknown factors also seem to play a role.

摘要

目的

本队列研究旨在确定与无胆囊疾病的参与者相比,通过对一般人群进行筛查发现患有胆囊疾病的受试者的总体死亡率是否增加,并探讨死因。

方法

该研究人群(N=5928)于 1982 年至 1992 年进行了检查,包括腹部超声检查以评估胆囊状况、体格检查、血液样本和关于病史的问卷。参与者通过国家登记处进行随访,直至 2015 年。建立了多个调整后的 Cox 回归模型。

结果

胆囊疾病的患病率为 10%。在中位 24.7 年的随访期间,死亡率为 46%,有 1%的参与者失访。总体死亡率和心血管疾病死亡与胆囊疾病显著相关。死因不明与胆囊疾病显著相关,而癌症和胃肠道疾病的死亡与胆囊疾病无关。未发现超声证实的胆囊结石或胆囊切除术与死亡率存在差异。

结论

胆囊疾病与总体死亡率增加以及心血管疾病死亡相关。胆囊结石可能被视为一种潜在的代谢心血管危险因素。其他未知因素似乎也发挥了作用。

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