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Central adiposity, regional fat distribution, and the risk of cholecystectomy in women
Abstract
Purpose: Whether central adiposity contributes independently of total adiposity to the risk for gall stones is inconclusive. We examined prospectively indicators of central adiposity in relation to the occurrence of gall stone disease. Methods: We evaluated the relationship between abdominal circumference and waist to hip ratio and risk of cholecystectomy in a cohort of women who had no history of gall stone disease. As part of the Nurses’ Health Study, the women reported on questionnaires their weights, heights, and waist and hip circumferences, and the occurrence of cholecystectomy. A total of 42 312 women, aged 39–66 years in 1986, who were free of prior gall stone disease, provided complete waist and hip circumference measurements in 1986. Results: We documented 3197 cases of cholecystectomy during 514 283 person years of follow up. After adjusting simultaneously for regional (waist circumference or waist to hip ratio) and total adiposity (body mass index) measures as well as for other risk factors of gall stone disease, women with a height adjusted waist circumference of 36 inches or larger had a relative risk (RR) of 1.96 (95% confidence interval (CI) 1.53–2.51; p trend <0.0001) compared with women with a height adjusted waist circumference of less than 26 inches. Waist to hip ratio was directly associated with the risk, with an RR of 1.39 (95% CI 1.16–1.66; p trend <0.0001) for women with a waist to hip ratio of 0.86 or higher compared with women with a waist to hip ratio of less than 0.70. Conclusion: Abdominal circumference and waist to hip ratio were associated with an increased risk of cholecystectomy, independently of body mass index in women.
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Both obesity and abdominal obesity increase the risk of stone formation and of requiring cholecystectomy because of higher likelihood of symptomatic stones.
“Both obesity and abdominal obesity increase the risk not only of stone formation but also of requiring surgical treatment (cholecystectomy) because of the higher likelihood of presenting with symptomatic stones [10,12,13].”
From Excess Body Weight and Gallstone Disease (2021) · cites this paper as [10]
The Results and Conclusion (pages unavailable) associate abdominal adiposity with increased cholecystectomy risk in women, independently of BMI. The Methods say symptomatic gallstones are the main indication for surgery, but the Discussion says the study did not screen for gallstones. It therefore does not establish that obesity increases stone formation or that a greater likelihood of stones becoming symptomatic explains the surgical risk. (LLM, conf=0.87)
Experimental — accuracy not yet measuredIncreased risk associated with abdominal adiposity can occur independently of BMI.
“The increased risk associated with abdominal adiposity can occur independently of BMI, as illustrated in 2 cohorts from the USA [10,11].”
From Excess Body Weight and Gallstone Disease (2021) · cites this paper as [10]
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Cited by
Sorted by citations
Gastrointestinal Complications of Obesity
Camilleri, M., Malhi, H., & Acosta, A. (2017) · Gastroenterology · doi:10.1053/j.gastro.2016.12.052 · Cited by 269
Excess Body Weight and Gallstone Disease
Stokes, C. S., & Lammert, F. (2021) · Visceral Medicine · doi:10.1159/000516418 · Cited by 58
Metadata
- Authors
- Tsai, C.-J., Leitzmann, M. F., Willett, W. C., & Giovannucci, E. L.
- Venue
- Gut
- Publisher
- BMJ
- Published
- 2006-02-14
- Volume
- 55
- Issue
- 5
- Pages
- 708-714
- ISSN
- 0017-5749
- 1468-3288
- Cited by
- 83
- References
- 1
- Language
- en
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