Gao Chaofeng, Liu Miaoyan, Sun Yuan, Zhao Zekun, Wei Fengxian, Xu Xiaodong
Department of General Surgery, Lanzhou University Second Hospital, Lanzhou, China.
Xi'an Medical University, Xi'an, China.
PLoS One. 2025 Apr 15;20(4):e0321733. doi: 10.1371/journal.pone.0321733. eCollection 2025.
Gallstones are a common digestive disorder, with a global prevalence of 10%-15%, posing a significant economic burden on public health. The formation of gallstones is closely associated with inflammation and nutritional status. The Advanced Lung Cancer Inflammation Index (ALI) is a composite measure for assessing inflammation and nutritional status; however, its relationship with gallstone risk remains unclear. This study aims to investigate the association between ALI and gallstone prevalence among U.S. adults.
This study is based on data from the 2017-2020 National Health and Nutrition Examination Survey (NHANES) and includes 5,826 adults aged 20 years and older. The Advanced Lung Cancer Inflammation Index (ALI) was calculated using body mass index (BMI), serum albumin levels, and the neutrophil-to-lymphocyte ratio (NLR). The prevalence of gallstones was determined through questionnaire surveys. Multivariable logistic regression models were employed to analyze the relationship between ALI and the risk of gallstones. Additionally, trend analysis, smooth curve fitting, and subgroup analyses were conducted.
The study results showed a significant positive correlation between ALI levels and the risk of gallstone disease. After fully adjusting for covariates, each unit increase in lnALI was associated with a 42% increase in the risk of gallstone disease (OR = 1.42, 95% CI: 1.12-1.80). Trend analysis indicated a significant dose-response relationship between ALI and gallstone risk (P for trend < 0.01). Subgroup analysis further revealed that the correlation between ALI and gallstone risk was more pronounced in females, non-diabetic patients, individuals with higher education levels, those with insufficient physical activity, and non-drinkers, with gender showing a significant interaction effect (interaction P < 0.05). Smooth curve fitting further validated the linear relationship between ALI and gallstone risk, and this association was particularly prominent in the female population.
This study demonstrates that ALI is significantly associated with the risk of gallstones, particularly among women. As a simple and readily accessible indicator, ALI may help identify high-risk populations and provide a new clinical tool for the prevention and management of gallstones. Future longitudinal studies should further validate these findings and evaluate the predictive value of ALI across different populations.
胆结石是一种常见的消化系统疾病，全球患病率为10%-15%，给公共卫生带来了巨大的经济负担。胆结石的形成与炎症和营养状况密切相关。晚期肺癌炎症指数（ALI）是一种用于评估炎症和营养状况的综合指标；然而，其与胆结石风险的关系尚不清楚。本研究旨在调查美国成年人中ALI与胆结石患病率之间的关联。
本研究基于2017-2020年国家健康与营养检查调查（NHANES）的数据，纳入了5826名20岁及以上的成年人。使用体重指数（BMI）、血清白蛋白水平和中性粒细胞与淋巴细胞比值（NLR）计算晚期肺癌炎症指数（ALI）。通过问卷调查确定胆结石的患病率。采用多变量逻辑回归模型分析ALI与胆结石风险之间的关系。此外，还进行了趋势分析、平滑曲线拟合和亚组分析。
研究结果显示ALI水平与胆结石疾病风险之间存在显著正相关。在对协变量进行充分调整后，lnALI每增加一个单位，胆结石疾病风险增加42%（OR = 1.42，95%CI：1.12-1.80）。趋势分析表明ALI与胆结石风险之间存在显著的剂量反应关系（趋势P < 0.01）。亚组分析进一步显示，ALI与胆结石风险之间的相关性在女性、非糖尿病患者、受教育程度较高者、体力活动不足者和不饮酒者中更为明显，性别显示出显著的交互作用（交互P < 0.05）。平滑曲线拟合进一步验证了ALI与胆结石风险之间的线性关系，这种关联在女性人群中尤为突出。
本研究表明ALI与胆结石风险显著相关，尤其是在女性中。作为一个简单且易于获取的指标，ALI可能有助于识别高危人群，并为胆结石的预防和管理提供一种新的临床工具。未来的纵向研究应进一步验证这些发现，并评估ALI在不同人群中的预测价值。
