Huang Xingyong, Hao Xuanyu, Wang Tingting, Zhang Xiaoyue, Wu Peng, Shen Lufan, Yang Yuanyuan, Zhang Wanchuan, Zhang Kai
Department of Gastroenterology, Endoscopic Center, Engineering Research Center of Ministry of Education for Minimally Invasive, Gastrointestinal Endoscopic Techniques, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Shenyang, 110004, Liaoning Province, China.
BMC Public Health. 2025 Jan 28;25(1):344. doi: 10.1186/s12889-024-21173-6.
Cholelithiasis are a condition that creates an economic and medical burden on society, and women are more susceptible to gallbladder stones. However, the effect of smoking on the development of gallstones remains controversial. No studies, to our knowledge, have discussed the association between smoke exposure and gallstones separately in men and women. We evaluated the association between smoking and gallstones in both sexes.
We conducted a cross-sectional analysis using data obtained from the National Health and Nutrition Examination Survey from 2017 to March 2020. The analysis was limited to individuals aged ≥ 20 years with complete information available. Self-reported smoking status, serum cotinine concentration, and self-reported gallstones conditions were combined to analyze the association of gallstones with smoking and cotinine concentration.
Of the 6,982 participants, a total of 6.2% (212) men and 14.5% (512) women reported having gallstones. Logistic regression analysis showed smoking and high serum cotinine level were risk factors associated with gallstones among women, both in the model 1 (current smoker: odds ratio [OR] = 1.563, 95% confidence interval [CI] = 1.044-2.339, p = 0.032; former smoker: OR = 1.434, 95% CI = 1.116-1.842, p = 0.007; cotinine ≥ 3 ng/mL: OR = 1.800, 95% CI = 1.247-2.596, p = 0.005; and cotinine 0.05-2.99 ng/mL: OR = 1.640, 95% CI = 1.188-2.263, p = 0.005) and model 2 (current smoker: OR = 1.588, 95% CI = 1.015-2.483, p = 0.044; cotinine ≥ 3 ng/mL: OR = 1.825; 95% CI = 1.181-2.821, p = 0.011; and cotinine 0.05-2.99 ng/mL: OR = 1.509, 95% CI = 1.075-2.126, p = 0.022). However, the association was statistically insignificant in men. The subgroup analysis showed the robustness of the association.
This study indicates smoking and elevated serum cotinine levels may be risk factors associated with the development of gallstones. Notably, the associations were specifically observed among women. The findings suggest the significance of smoking in the incidence of gallstones, which may potentially provide insights for future research on strategies to prevent gallstones, particularly among women. The validation of these findings necessitates the conduction of large-scale, high-quality prospective studies.
胆结石是一种给社会带来经济和医疗负担的疾病，女性更容易患胆结石。然而，吸烟对胆结石形成的影响仍存在争议。据我们所知，尚无研究分别探讨男性和女性中接触烟雾与胆结石之间的关联。我们评估了吸烟与两性胆结石之间的关联。
我们使用从2017年至2020年3月的美国国家健康和营养检查调查中获得的数据进行了横断面分析。分析仅限于年龄≥20岁且信息完整的个体。将自我报告的吸烟状况、血清可替宁浓度和自我报告的胆结石情况相结合，以分析胆结石与吸烟及可替宁浓度之间的关联。
在6982名参与者中，共有6.2%（212名）男性和14.5%（512名）女性报告患有胆结石。逻辑回归分析显示，吸烟和高血清可替宁水平是女性胆结石的危险因素，在模型1（当前吸烟者：比值比[OR]=1.563，95%置信区间[CI]=1.044-2.339，p=0.032；既往吸烟者：OR=1.434，95%CI=1.116-1.842，p=0.007；可替宁≥3 ng/mL：OR=1.800，95%CI=1.247-2.596，p=0.005；可替宁0.05-2.99 ng/mL：OR=1.640，95%CI=1.188-2.263，p=0.005）和模型2（当前吸烟者：OR=1.588，95%CI=1.015-2.483，p=0.044；可替宁≥3 ng/mL：OR=1.825；95%CI=1.181-2.821，p=0.011；可替宁0.05-2.99 ng/mL：OR=1.509，95%CI=1.075-2.126，p=0.022）中均如此。然而，在男性中这种关联无统计学意义。亚组分析显示了这种关联的稳健性。
本研究表明吸烟和血清可替宁水平升高可能是与胆结石形成相关的危险因素。值得注意的是，这种关联在女性中尤为明显。这些发现提示了吸烟在胆结石发病中的重要性，这可能为未来预防胆结石策略的研究提供见解，特别是在女性中。这些发现的验证需要进行大规模、高质量的前瞻性研究。
