1Department of Family Medicine,MacKay Memorial Hospital,Taipei,10449, Taiwan.
2Department of Family Medicine,Chinese Medical University Hospital Taipei Branch,Taipei,11449,Taiwan.
Br J Nutr. 2019 Apr;121(8):955-960. doi: 10.1017/S000711451900028X. Epub 2019 Feb 11.
Gallstone disease (GSD) represents a significant health burden and is reported to be strongly related to obesity. This study examined the effect of sex on the association of BMI, waist circumference (WC) and percentage body fat mass (%FM) with GSD. We enrolled 15 671 middle-aged Taiwanese adults undergoing a physical check-up at a health examination centre. Multiple logistic regression analysis was conducted to identify the association of BMI, WC and %FM with the presence of GSD. AUC of the receiver-operating characteristic (ROC) curves were calculated for BMI, WC and %FM to compare their respective ability to correctly classify patients with GSD. From our findings, GSD prevalence was 8·1 % in men and 6·3 % in women. The percentage of markedly increased obesity indicators was significantly higher in patients with GSD than in those without GSD. Multivariate analysis showed that all obesity indicators were significant predictors of the presence of GSD in women after adjustment. In men, only BMI and WC were significantly associated with the presence of GSD. In the ROC curve analysis, BMI and WC were the best predictors of GSD risk in women and men, respectively. The obesity indicators better predicted the presence of GSD in women than in men. In conclusion, the best obesity indicator of GSD risk differed by sex. In addition to body weight, fat mass and central obesity were associated with GSD risk in women. In men, central obesity may play a more important role in predicting GSD risk.
胆囊疾病(GSD)是一种严重的健康负担,据报道与肥胖密切相关。本研究探讨了性别对 BMI、腰围(WC)和体脂肪百分比(%FM)与 GSD 之间关联的影响。我们招募了 15671 名在健康检查中心进行体检的中年台湾成年人。采用多因素逻辑回归分析来确定 BMI、WC 和 %FM 与 GSD 存在的关联。计算了 BMI、WC 和 %FM 的受试者工作特征(ROC)曲线的 AUC,以比较它们各自正确分类 GSD 患者的能力。从我们的研究结果来看,男性 GSD 的患病率为 8.1%,女性为 6.3%。患有 GSD 的患者中明显增加的肥胖指标的比例明显高于没有 GSD 的患者。多变量分析表明,所有肥胖指标均为女性 GSD 存在的显著预测因素,调整后。在男性中,仅 BMI 和 WC 与 GSD 的存在显著相关。在 ROC 曲线分析中,BMI 和 WC 分别是女性和男性 GSD 风险的最佳预测指标。肥胖指标对女性 GSD 风险的预测优于男性。总之,GSD 风险的最佳肥胖指标因性别而异。除体重外,脂肪量和中心性肥胖与女性 GSD 风险相关。在男性中,中心性肥胖可能在预测 GSD 风险方面发挥更重要的作用。