Moerman C J, Smeets F W, Kromhout D
National Institute of Public Health and Environmental Protection, Department of Chronic Disease and Environmental Epidemiology, Bilthoven, The Netherlands.
Ann Epidemiol. 1994 May;4(3):248-54. doi: 10.1016/1047-2797(94)90104-x.
In a long-term follow-up study of middle-aged men, the relation between the intake of energy, nutrients, and foods and the 25-year incidence of clinically diagnosed gallstones was studied. Information on the presence of gallstones was obtained by self-report and verified through medical records after death. Of 860 men, 54 developed symptomatic gallstones, yielding an incidence rate of 3.1/1000 person-years. The present study provides a comprehensive picture of dietary risk factors for clinically diagnosed gallstones based on a long-term follow-up. Calcium intake was inversely associated with gallstone incidence in the univariate and multivariate Cox proportional hazards analyses (hazard ratio (HR) upper tertile: 0.3; 95% CI: 0.1 to 0.7). A positive association with sugars (monosaccharides and disaccharides) appeared after the introduction of age, body mass index, calcium intake, and the intake of energy from nutrients other than sugars into the model (HR upper tertile: 2.3; 95% CI: 1.0 to 4.8). Calcium may alter the composition of bile by preventing the reabsorption of secondary bile acids in the colon, whereas sugars may influence bile composition through lipoprotein metabolism.
在一项针对中年男性的长期随访研究中，研究了能量、营养素和食物摄入量与临床诊断胆结石25年发病率之间的关系。通过自我报告获取胆结石存在的信息，并在死亡后通过病历进行核实。在860名男性中，54人出现有症状的胆结石，发病率为3.1/1000人年。本研究基于长期随访，全面呈现了临床诊断胆结石的饮食风险因素。在单变量和多变量Cox比例风险分析中，钙摄入量与胆结石发病率呈负相关（风险比（HR）上三分位数：0.3；95%置信区间：0.1至0.7）。在将年龄、体重指数、钙摄入量以及除糖以外的营养素能量摄入量纳入模型后，发现与糖（单糖和双糖）呈正相关（HR上三分位数：2.3；95%置信区间：1.0至4.8）。钙可能通过阻止结肠中次级胆汁酸的重吸收来改变胆汁成分，而糖可能通过脂蛋白代谢影响胆汁成分。
