Sex disparities in gallstone disease: insights from the MAUCO prospective population-based cohort study.

Publisher: BMJ Publishing Group Ltd & British Society of Gastroenterology Country of Publication: England NLM ID: 101660690 Publication Model: Electronic Cited Medium: Print ISSN: 2054-4774 (Print) Linking ISSN: 20544774 NLM ISO Abbreviation: BMJ Open Gastroenterol Subsets: MEDLINE

Original Publication: [London] : BMJ Publishing Group Ltd & British Society of Gastroenterology, [2014]-

Gallstones*/epidemiology; Humans ; Female ; Middle Aged ; Male ; Prospective Studies ; Adult ; Aged ; Incidence ; Prevalence ; Risk Factors ; Sex Factors ; Spain/epidemiology ; Cholecystectomy/statistics & numerical data ; Ultrasonography

Objective: To investigate factors associated with the prevalence and incidence of gallstone disease (GSD) in women and men of the MAUCO population-based prospective cohort.
Design: 8948 MAUCO participants (aged 38-74 years) underwent abdominal ultrasound at baseline (2015-2019); 4385 received follow-up ultrasound at years 2 or 4. Factors associated with prevalent GSD were assessed using Poisson multiple regression and with incident GSD using Cox regression models.
Results: GSD prevalence was 40.4% in women (13.1% gallstones, 27.3% cholecystectomies) and 17.1% in men (8.9% gallstones, 8.2% cholecystectomies). In men, GSD prevalence rate ratio (PRR) by age in >64 years was 3.85 (95% CI 3.00 to 4.94), doubling that of women's PRR 1.78 (95% CI 1.57 to 2.01). In women, waist circumference and diabetes were stronger GSD factors; a higher number of children and worse metabolic and socioeconomic conditions were also highlighted. GSD men had higher cardiovascular disease and a family history of GSD and gallbladder cancer. 198 GSD cases developed during follow-up, with incidence increasing by 2% (95% CI 1.005% to 1.03%) per each centimetre above the ideal waist circumference, statistically significant only in women. In men, age was the strongest factor for incidence, followed by a family history of GSD and low high-density lipoprotein increased incidence risk.
Conclusions: GSD burden was high in this population; a third of women had their gallbladder removed, which may pose them at risk of other health problems. Abdominal obesity was the only preventable GSD risk factor, highlighting the need for effective public health policies promoting obesity reduction.
Competing Interests: Competing interests: None declared.
(© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

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Keywords: CHOLECYSTECTOMY; GALLSTONE DISEASE; GALLSTONES; OBESITY

Date Created: 20240929 Date Completed: 20240929 Latest Revision: 20241003

20241003

PMC11440185

10.1136/bmjgast-2024-001457

39343441