Central adiposity, regional fat distribution, and the risk of cholecystectomy in women
- 1Channing Laboratory, Department of Medicine, Harvard Medical School and Brigham and Women’s Hospital, Boston, MA, USA, and Division of Digestive Diseases and Nutrition, University of Kentucky Medical Center, Lexington, Kentucky, USA
- 2Channing Laboratory, Department of Medicine, Harvard Medical School and Brigham and Women’s Hospital, Boston, MA, USA, and Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
- 3Channing Laboratory, Department of Medicine, Harvard Medical School and Brigham and Women’s Hospital, Boston, MA, USA, and Departments of Nutrition and Epidemiology, Harvard School of Public Health, Boston, MA, USA
- Correspondence to:
Dr C-J Tsai
Division of Digestive Diseases and Nutrition, University of Kentucky Medical Center, 800 Rose St, Lexington, Kentucky 40536-0298, USA;
- Accepted 25 October 2005
- Revised 12 October 2005
- Published Online First 14 February 2006
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.
Grant support for the study was obtained from research grants (CA55075 and DK46200) from the National Institutes of Health.
Conflict of interest: None declared.