Zheng Yangyang, Chen Xiaoli, Ge Yunpeng, Shi Haowei, Guo Shiqi, Tan Wendan, Song Jinghai
Department of General Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China.
State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, 300020, China.
BMC Gastroenterol. 2025 Jul 22;25(1):529. doi: 10.1186/s12876-025-04099-0.
Anthropometric measurements and lipid profiles are associated with the onset of gallstone disease, with these associations exhibiting sex-specific variations. This study investigated the association between the prevalence of gallstones and two anthropometric-lipid markers, namely Lipid Accumulation Products (LAP) and Cardiometabolic Index (CMI), while also assessing the presence of sex disparities.
Data from the 2017-2020 National Health and Nutrition Examination Survey (NHANES) were analyzed, including 3,541 participants aged 20 years or older with complete information. Weighted logistic regression, restricted cubic spline modeling, and subgroup analyses were employed to assess the relationship between LAP and CMI and gallstone disease, as well as to investigate potential sex-specific differences. An analysis of the receiver operating characteristic (ROC) curve was performed to assess the prediction accuracy of indices and to determine appropriate cutoff values.
Elevated LAP and CMI were significantly correlated with an increased prevalence of gallstone disease among women, whereas no significant association was found in men. For each unit increase in log2-LAP, the multivariable-adjusted odds ratio (OR) for gallstone disease was 1.375 (95% CI: 1.143-1.655). For each 1-point increase in CMI, the multivariable-adjusted OR was 1.408 (95% CI: 1.098-1.806). Quartile analysis demonstrated that higher levels of LAP and CMI were significantly associated with an increased prevalence of gallstones. The associations between CMI, LAP, and the prevalence of gallstones were consistent across all subgroups (p for interaction > 0.05). LAP exhibiting the largest AUC, demonstrating high accuracy in screening for high-risk individuals for gallstone disease, comparable to traditional indices.
The study revealed a positive association between LAP, CMI, and the prevalence of gallstones, observed exclusively among women. The findings suggest that prioritizing the reduction of LAP and CMI is crucial for preventing gallstone disease in women.
人体测量指标和血脂谱与胆结石疾病的发病有关，且这些关联存在性别差异。本研究调查了胆结石患病率与两种人体测量 - 血脂标志物，即脂质蓄积产物（LAP）和心脏代谢指数（CMI）之间的关联，同时评估了性别差异情况。
分析了2017 - 2020年国家健康与营养检查调查（NHANES）的数据，包括3541名20岁及以上且信息完整的参与者。采用加权逻辑回归、受限立方样条建模和亚组分析来评估LAP和CMI与胆结石疾病之间的关系，以及调查潜在的性别差异。进行了受试者工作特征（ROC）曲线分析，以评估指标的预测准确性并确定合适的截断值。
LAP和CMI升高与女性胆结石疾病患病率增加显著相关，而在男性中未发现显著关联。log2 - LAP每增加一个单位，胆结石疾病的多变量调整比值比（OR）为1.375（95%CI：1.143 - 1.655）。CMI每增加1分，多变量调整OR为1.408（95%CI：1.098 - 1.806）。四分位数分析表明，较高水平的LAP和CMI与胆结石患病率增加显著相关。CMI、LAP与胆结石患病率之间的关联在所有亚组中均一致（交互作用p>0.05）。LAP的曲线下面积（AUC）最大，在筛查胆结石疾病高危个体方面显示出与传统指标相当的高精度。
该研究揭示了LAP、CMI与胆结石患病率之间存在正相关，且仅在女性中观察到。研究结果表明，优先降低LAP和CMI对于预防女性胆结石疾病至关重要。
