空腹血糖水平与胆石症发病风险的关系

梁明杨; 魏垚臣; 王一鸣; 崔皓哲; 孙苗苗; 刘四清; 曹立瀛

doi:10.3969/j.issn.1001-5256.2019.11.025

空腹血糖水平与胆石症发病风险的关系

DOI: 10.3969/j.issn.1001-5256.2019.11.025

1. 华北理工大学研究生院
2. 华北理工大学附属开滦总医院肝胆外科

基金项目:

河北省卫生和计划生育委员会重点科技研究计划(20171435)；

详细信息

中图分类号: R575.62
计量
- 文章访问数: 1377
- HTML全文浏览量: 40
- PDF下载量: 288
- 被引次数: 0
出版历程
- 收稿日期: 2019-06-28
- 出版日期: 2019-11-20

Association between fasting blood glucose and the risk of cholelithiasis

Graduate School of North China University of Science and Technology

Research funding:

摘要

摘要: 目的探讨空腹血糖与胆石症发病风险的关系。方法选取开滦研究中在2006-2007年度健康体检中进行空腹血糖及肝、胆超声检查的87 513例观察对象,根据血糖检测结果,将观察对象分为血糖正常组（n=73 456）﹑空腹血糖受损组（n=7165）和糖尿病组（n=6892）。采用log-rank检验比较不同分组间胆石症的累积发病率;采用Cox比例风险模型分析不同空腹血糖水平分组对新发胆石症的影响,计算风险比（HR）和95%可信区间（95%CI）;采用分层分析比较在不同性别﹑血脂水平和BMI人群中不同空腹血糖分组间胆石症发病风险。正态分布的计量资料多组间比较采用单因素方差分析;偏态分布的计量资料多组间比较采用Krustal-willis H秩和检验。分类资料组间差异比较采用χ2检验。结果血糖正常组、空腹血糖受损组、糖尿病组的胆石症累积发病率分别为10. 91%、12. 17%和18. 86%,三组胆石症累积发病率差异有统计学意义（χ2=27. 94,P <0. 05）。在Cox比例风险模型分析中,连续校正其他因素后,与血糖正常组相比,空腹血糖受损...
- 胆结石 /
- 糖尿病 /
- 血糖 /
- 危险因素
Abstract: Objective To investigate the association between fasting blood glucose and the risk of cholelithiasis. Methods A total of87513 individuals who underwent fasting blood glucose test and liver/biliary ultrasound in health examination in Kailuan from 2006 to 2007 were enrolled as subjects,and according to the results of blood glucose test,the subjects were divided into normal blood glucose group with73456 subjects,impaired fasting blood glucose group with 7165 subjects,and diabetic group with 6892 subjects. The log-rank test was used to compare the cumulative incidence rate of cholelithiasis between groups; the Cox proportional hazards model was used to analyze the influence of different levels of fasting blood glucose on new-onset cholelithiasis and calculate hazard ratio( HR) and 95% confidence interval( CI); a stratified analysis was used to compare the risk of cholelithiasis between the individuals with different levels of fasting blood glucose in the groups with different sexes,blood lipid levels,and levels of body mass index( BMI). A one-way analysis of variance was used for comparison of normally distributed continuous data between multiple groups,and the Kruskal-Wallis H test was used for comparison of continuous data with skewed distribution between multiple groups. The chi-square test was used for comparison of categorical data between groups. Results There was a significant difference in the cumulative incidence rate of cholelithiasis between the normal blood glucose group,the impaired fasting blood glucose group,and the diabetic group( 10. 91% vs 12. 17% vs 18. 86%,χ2= 27. 94,P < 0. 05). After the continuous adjustment for the other factors in the Cox proportional hazards model analysis,compared with the normal blood glucose group,the impaired fasting blood glucose group had a risk of new-onset cholelithiasis of 0. 97( 95% CI: 0. 85-1. 11,P = 0. 587),and the diabetic group had a risk of new-onset cholelithiasis of 1. 15( 95% CI: 1. 01-1. 30,P = 0. 019). The stratified analysis showed that diabetes was a risk factor for new-onset cholelithiasis in male individuals( HR = 1. 16,95% CI: 1. 01-1. 33,P = 0. 043),individuals with normal blood lipids( HR = 1. 22,95% CI: 1. 01-1. 49,P = 0. 044),and individuals with overweight based on BMI( HR = 1. 16,95% CI:1. 01-1. 35,P = 0. 048). Conclusion Diabetes can increase the risk of cholelithiasis. Diabetes is an independent risk factor for cholelithiasis in men,individuals with normal blood lipids,and individuals with overweight based on BMI.
- cholelithiasis /
- diabetes mellitus /
- blood glucose /
- risk factors

HTML全文

参考文献(33)

[1] PORTINCASA P,MOSCHETTA A,PALASCIANO G. Cholesterol gallstone disease[J]. Lancet(North American Edition),2006,368(9531):230-239.

[2] STINTON LSM,MYERS RP,SHAFFER EA. Epidemiology of gallstones[J]. Gastroenterol Clin North Am,2010,39(2):157-169.

[3] CHEN CH,HUANG MH,YANG JC,et al. Prevalence and risk factors of nonalcoholic fatty liver disease in an adult population of Taiwan:Metabolic significance of nonalcoholic fatty liver disease in nonobese adults[J]. J Clin Gastroenterol,2006,40(8):745-752.

[4] AERTS R,PENNINCKX F. The burden of gallstone disease in Europe[J]. Aliment Pharmacol Ther,2003,18(Suppl 3):49-53.

[5] ZHU L,AILI A,ZHANG C,et al. Prevalence of and risk factors for gallstones in Uighur and Han Chinese[J]. World J Gastroenterol,2014,20(40):14942-14949.

[6] WANG YM,ZHAO L,CAO LY,et al. Investigation of cholelithiasis prevalence in Kailuan population[J]. J Hepatobiliary Surg,2015,23(6):432-437.(in Chinese)王一鸣，赵利，曹立瀛，等．开滦人群胆石症患病率调查研究[J]．肝胆外科杂志，2015,23(6):432-437.

[7] PORTINCASA P,MOSCHETTA A,PETRUZZELLI M,et al.Gallstone disease:Symptoms and diagnosis of gallbladder stones[J]. Best Pract Res CL GA,2006,20(6):1017.

[8] BROWNING JD,HORTON JD. Gallstone disease and its complications[J]. Semin Gastrointest Dis,2003,14(4):165-177.

[9] LIU T,TAO M,WANG WC,et al. Relationship between alcohol consumption and new-onset cholelithiasis:A multicentre retrospective study(A report of 77 755 cases)[J]. Chin J Dig Surg,2018,17(1):76-83.(in Chinese)刘通，陶明，王万超，等．酒精摄入量与新发胆石症关系的多中心回顾性研究(附77755例报告)[J]．中华消化外科杂志，2018,17(1):76-83.

[10] GU YC,HE XD,YU JC,et al. Metabolism-related risk factors of cholelithiasis among Beijing residents:A case-control study[J]. Acta Acad Med Sin,2012,34(1):38-40.(in Chinese)古应超，何小东，于健春，等．北京地区代谢因素与胆囊结石患病风险的病例对照研究[J]．中国医学科学院学报，2012,34(1):38-40.

[11] NOEL RA,BRAUN DK,PATTERSON RE,et al. Increased risk of acute pancreatitis and biliary disease observed in patients with type 2 diabetes[J]. Diabetes Care,2009,32(5):834-838.

[12] BOLAND LL,FOLSOM AR,ROSAMOND WD. Hyperinsulinemia,dyslipidemia,and obesity as risk factors for hospitalized gallbladder disease:A prospective study[J]. Ann Epidemiol,2002,12(2):131-140.

[13] WU S,HUANG Z,YANG X,et al. Prevalence of ideal cardiovascular health and its relationship with the 4-year cardiovascular events in a northern Chinese industrial city[J]. Circ Cardiovasc Qual Outcomes,2012,5(4):487-493.

[14] Chinese Diabetes Society. Chinese guidelines for the prevention and treatment of type 2 diabetes(2017 edition)[J]. Chin J Pract Int Med,2018,38(4):292-344.(in Chinese)中华医学会糖尿病学分会．中国2型糖尿病防治指南(2017年版)[J]．中国实用内科杂志，2018,38(4):292-344.

[15] LIU LS,WANG W,YAO CH,et al. Chinese guidelines for the prevention and treatment of hypertension(2010 grass-roots edition)[J]. Chin J Hypertension,2010,18(1):18-37.(in Chinese)刘力生，王文，姚崇华，等．中国高血压防治指南(2010年基层版)[J]．中华高血压杂志，2010,18(1):18-37.

[16] Committee of Chinese guidelines on prevention and treatment of dyslipidemia in adults. Chinese guidelines on prevention and treatment of dyslipidemia in adults[J]. Chin J Cardiol,2007,35(5):390-419.(in Chinese)中国成人血脂异常防治指南制订联合委员会．中国成人血脂异常防治指南[J]．中国心血管病杂志，2007,35(5):390-419

[17] FENG X,WANG G,LI N,et al. The association between fasting blood glucose and the risk of primary liver cancer in Chinese males:A population-based prospective study[J]. Br J Cancer,2017,117(9):1405-1411.

[18] JASWINDER SS,SHOWKAT AZ,SHAFKATULLAH K,et al.Prevalence of gallstone disease in patients with type 2 diabetes and the risk factors in North Indian population:A case control study[J]. Indian J Gastroenterology,2014,33(6):507-511.

[19] CHEN JY,HSU CT,LIU JH,et al. Clinical predictors of incident gallstone disease in a Chinese population in Taipei,Taiwan[J]. BMC Gastroenterology,2014,14(1):83.

[20] ALI S,AHAMAD ST,TALPUR AS,et al. Prevalence of Noninsulin-dependent diabetes mellitus among patients with cholelithiasis:A single-centered,cross-sectional study[J].Cureus,2018,10(4):e2444.

[21] SUN H,TANG H,JIANG S,et al. Gender and metabolic differences of gallstone diseases[J]. World J Gastroenterol,2009,15(15):1886-1891.

[22] CHEN LY,QIAO QH,ZHANG SC,et al. Metabolic syndrome and gallstone disease[J]. World J Gastroenterol,2012,18(31):4215-4220.

[23] ZHU Q,SUN X,JI X,et al. The association between gallstones and metabolic syndrome in urban Han Chinese:A longitudinal cohort study[J]. Sci Rep,2016,6:29937.

[24] WANG XP,MENG XZ. Risk factors for gallstones complicated by acute biliary pancreatitis[J]. J Clin Hepatol,2018,34(8):1728-1732.(in Chinese)王宪鹏，孟宪志．胆囊结石并发急性胆源性胰腺炎的危险因素分析[J]．临床肝胆病杂志，2018,34(8):1728-1732.

[25] KIM SS,LEE JG,KIM DW,et al. Insulin resistance as a risk factor for gallbladder stone formation in Korean postmenopausal women[J]. Korean J Intern Med,2011,26(3):285-293.

[26] ZHOU J,ZHOU Q,WANG DP,et al. Sitting behavior and physical activity with abnormal blood lipid[J]. J Peking Univ:Health Sci,2017,49(3):418-423.(in Chinese)周景，周倩，王东平，等．静坐行为和体力活动与血脂异常[J]．北京大学学报:医学版，2017,49(3):418-423.

[27] ETMINAN M,DELANEY JAC,BRESSLER B,et al. Oral contraceptives and the risk of gallbladder disease:A comparative safety study[J]. Can Med Assoc J,2011,183(8):899-904.

[28] LIU CM. A population-based cohort study of symptomatic gallstone disease in diabetic patients[J]. World J Gastroenterol,2012,18(14):1652-1659.

[29] BIDDINGER SB,HAAS JT,YU BB,et al. Hepatic insulin resistance directly promotes formation of cholesterol gallstones[J]. Nat Med,2008,14(7):778-782.

[30] LI V KM,PULIDO N,FAJNWAKS P,et al. Predictors of gallstone formation after bariatric surgery:A multivariate analysis of risk factors comparing gastric bypass,gastric banding,and sleeve gastrectomy[J]. Surg Endosc,2009,23(7):1640-1644.

[31] SMELT AHM. Triglycerides and gallstone formation[J]. Clin Chim Acta,2010,411(21-22):1625-1631.

[32] DANIEL MS,SKAABY T,LARS TS,et al. Metabolic biomarkers and gallstone disease-a population-based study[J].Scand J Gastroenterol,2017,52(11):1-8.

[33] WILD S,ROGLIC G,GREEN A,et al. Global prevalence of diabetes:Estimates for the year 2000 and projections for 2030[J]. Diabetes Care,2004,27(5):1047-1053.

施引文献

资源附件(0)

访问统计