Central adiposity nearly doubles cholecystectomy risk in women

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Central adiposity, independent of weight, and a high waist-to-hip ratio, are risk factors for cholecystectomy in women, researchers report in the May issue of Gut. Those with the largest waist circumference had nearly double the risk of women with smallest waists.

Analysis of data for 42,312 participants in the Nurses' Health Study was carried out at the University of Kentucky Medical Center, Lexington by Dr. C-J Tsai and associates. The researchers looked at risk factors for cholecystectomy in 42,312 women who women ranged in age from 39 to 66 years old and were free of gallstone disease at baseline in 1986. Baseline waist and hip circumference data were also noted.

By the year 2000 and after 514,283 person years of follow-up, there were 3127 cases of cholecystectomy. After adjusting for regional and total adiposity (waist-to-hip ratio and body mass index) and other risk factors for gall stone disease, women with a height-adjusted waist circumference greater than 36 inches had a relative risk (RR) of 1.96 for cholecystectomy compared with women with a waist circumference less than 26 inches.

"Waist-to-hip ratio was directly associated with risk," the authors write. A ratio of 0.86 or greater had a relative risk of cholecystectomy of 1.39 compared with women with a ratio of 0.70 or less. Waist-to-hip ratio was independent of total body mass index as a risk factor for gall stone disease and the need for surgery.

Ultrasonography screening was not performed in this study. As a result, Dr. Tsai points out that the prevalence of gall stones was probably underestimated because most gall stones are asymptomatic.