关键词: 胆石症, 心血管疾病, 危险因素, 队列研究

Abstract:

Objective To investigate the effect of gallstone on the incidence of cardiovascular diseases (CVD). Methods A prospective cohort study was conducted to analyze a total of 126 847 employees who participated in the health checkup of the Kailuan Hospital for the first time in 2006 and 2008, and collected their physical examination data. The population was divided into gallstone group (n=2 901) and non-gallstone group (n=115 615). The incidence of CVD in each group was followed-up and collected. The cumulative incidence of CVD in different groups was calculated by life table method, and the difference of cumulative incidence of CVD between the two groups was compared by Log-rank test. Cox proportional risk model was used to analyze the effect of gallstone on CVD risk. The risk ratio and 95% confidence interval of CVD by gender were analyzed. Results There were significant differences in age, male ratio, body mass index (BMI), triglyceride (TG), physical exercise, smoking, alcohol consumption, and hypertension between the gallstone group and the nongallstone group (P<0.05). During the average follow-up period of 10.03 years, a total of CVD 7 205 cases occurred, including 1 674 cases of myocardial infarction, 5 695 cases of stroke, 164 cases of stroke complicated with myocardial infarction, 4 772 cases of ischemic stroke and 1 101 cases of hemorrhagic stroke, 178 cases of hemorrhagic stroke complicated with ischemic stroke. The cumulative incidences of CVD, myocardial infarction, stroke, ischemic stroke and hemorrhagic stroke in gallstone group were 7.98%, 1.96%, 6.24%, 5.01% and 1.46%, respectively. In the non-gallstone group, the cumulative incidences of CVD, myocardial infarction, stroke, ischemic stroke and hemorrhagic stroke were 5.48%, 1.32%, 4.28%, 3.54% and 0.80%, respectively. Logrank test showed that there were significant differences between the two groups (P<0.05). The results of Cox proportional risk model showed that after adjusting for confounding factors, the HR (95%CI) of CVD in gallstone group was 1.31 (1.15~1.49), the HR (95%CI) of myocardial infarction was 1.25 (0.95~1.64), the HR (95%CI) of stroke was 1.32 (1.14~1.52), the HR (95%CI) of ischemic stroke was 1.28 (1.09~1.51), the HR value (95%CI) of hemorrhagic stroke was 1.43 (1.05~1.96). The risk of cvd, stroke and ischemic stroke in male patients with gallstone was lower than that in female patients with gallstone. Conclusion Gallstone disease is an independent risk factor for the incidence of cardiovascular diseases.

Key words: gallstone disease, cardiovascular diseases, risk factors, cohort study