Moerman C J, Berns M P, Smeets F W, Kromhout D
Department of Chronic Disease and Environmental Epidemiology, National Institute of Public Health and Environmental Protection, Bilthoven, The Netherlands.
Int J Obes Relat Metab Disord. 1994 Jun;18(6):435-9.
Obesity is considered to be an important risk factor for the formation of gallstones. The relationship is well established for women but not for men. In a long-term follow-up study of middle-aged men the relationship between various markers of obesity and the incidence of clinically diagnosed gallstones during 25 years of follow-up was studied. Information on the presence of gallstones was obtained by self-report and verified through medical records after death. Of the 860 men who were between 40 and 59 years old at the start of the study, 54 developed gallstones, yielding an incidence rate of 3.1/1000 person-years. Cox proportional hazard models were used to examine the associations between the risk factors and newly diagnosed gallstones. Univariate analysis revealed that the subscapular-to-triceps skinfold thickness ratio (STR) yields a significant positive association (HR upper quartile: 2.5, 95% CI: 1.1-5.7). Subscapular skinfold thickness had a borderline significant, positive association, which became significant after exclusion of subjects who developed symptomatic gallstones within the first 3 years of follow-up (HR upper quartile: 2.5, 95% CI: 1.0-6.2). The multivariate model revealed that the association of STR with clinically diagnosed gallstones was independent of Body Mass Index. Our results indicate that regional fat distribution, as measured by the subscapular-to-triceps skinfold thickness ratio, may play an important role in the formation of gallstones in men, as was previously found for women in other studies.
肥胖被认为是胆结石形成的一个重要风险因素。这种关系在女性中已得到充分证实，但在男性中尚未明确。在一项针对中年男性的长期随访研究中，研究了肥胖的各种指标与随访25年间临床诊断胆结石发病率之间的关系。关于胆结石存在情况的信息通过自我报告获得，并在死亡后通过病历进行核实。在研究开始时年龄在40至59岁之间的860名男性中，有54人患上了胆结石，发病率为3.1/1000人年。使用Cox比例风险模型来检验风险因素与新诊断胆结石之间的关联。单因素分析显示，肩胛下与肱三头肌皮褶厚度比（STR）呈现出显著的正相关（HR上四分位数：2.5，95%CI：1.1 - 5.7）。肩胛下皮褶厚度有临界显著的正相关，在排除随访前3年内出现症状性胆结石的受试者后变得显著（HR上四分位数：2.5，95%CI：1.0 - 6.2）。多变量模型显示，STR与临床诊断胆结石的关联独立于体重指数。我们的结果表明，如通过肩胛下与肱三头肌皮褶厚度比所测量的区域脂肪分布，可能在男性胆结石形成中起重要作用，正如之前其他研究在女性中所发现的那样。
