胆囊结石和肥胖及血脂代谢异常的相关性

目的 了解上海张江地区成年人胆囊结石的患病情况及其与肥胖、血脂代谢异常的相关性。方法 回顾性分析2019年1月至2019年12月在上海中医药大学附属曙光医院东院体检的24 914名20～79岁的张江地区成年常驻居民的腹部B超、体质量指数和血脂资料。以10岁为一个年龄段进行统计，比较各年龄段胆囊结石和肥胖发生率，采用Logistic回顾分析胆囊结石相关危险因素。结果 总胆囊结石患病率为2.78%（693/24 914），随年龄段的上升而增高，20～59岁4个年龄段的胆囊结石患病率均存在统计学差异（P＜0.05）；按男女性别分别统计也均呈现相同的上升趋势和统计学差异情况；30～49岁2个年龄段男性的胆囊结石患病率高于同年龄段女性。总肥胖发生率为13.12%，男性肥胖人群分布呈纺锤形，以40～49岁年龄段为高峰；女性肥胖人群分布呈线性，随年龄增长不断升高。20～59岁4个年龄段男性肥胖率明显高于女性（P＜0.05）。50岁以下育龄期女性中，患有胆囊结石的女性LDL水平高于无胆囊结石的女性（P＜0.05）。Logistic分析显示女性（OR 1.263，95%CI 1.061～1.502）、50岁以上（OR 3.290，95%CI 2.820～3.838）、肥胖（OR 2.045，95%CI 1.709～2.449）、LDL≥3.4 mmol/L（OR 1.384，95%CI 1.111～1.724）、HDL（男性＜1.16 mmol/L，女性＜1.29 mmol/L）（OR 2.135，95%CI 1.786～2.551）的人群胆囊结石患病风险相对增加。结论 肥胖和HDL、LDL异常是胆囊结石发病的重要危险因素。其中高肥胖率在中青年男性中极为突出，而育龄期女性尤其需要关注LDL水平。

Correlation between gallstones and obesity and dyslipidemia

Objective To investigate the prevalence of gallstones and its association with obesity and dyslipidemia in adults in Zhangjiang area of Shanghai. Methods The data of abdominal B-ultrasound, body mass index and blood lipids of 24 914 residents in Zhangjiang area who underwent physical examination in the East Hospital of Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from Jan. 2019 to Dec. 2019 were retrospectively analyzed. Taking 10 years as an age group, the prevalence of gallstones and obesity were compared according to age group, and the related risk factors were analyzed retrospectively by Logistic. Results The total prevalence rate of gallstone among 24 914 subjects was 2.78%, which increased with the increase of age group. There were statistical differences in the four age groups from 20 to 59 years old (allP<0.05), and the same trend and statistical differences were presented by gender. The prevalence rate of gallstones in males aged 30~49 was higher than that of females in the same age group. The total incidence rate of obesity was 13.12%. The distribution of male obesity was fusiform, and the peak was 40~49 years old. The distribution of female obesity is linear and increased with age. The obesity rate of male was significantly higher than that of female in 20~59 years old (all P<0.05). LDL levels in women under 50 years old with gallstones were higher than those without gallstones (P<0.05). Logistic analysis showed that the risk of gallstone was relatively increased in women (OR 1.263, 95%CI 1.061~1.502), over 50 years old (OR 3.290, 95%CI 2.820~3.838), obesity (OR 2.045, 95%CI 1.709~2.449), LDL≥3.4 mmol/L (OR 1.384, 95%CI 1.111~1.724), HDL (<1.16 mmol/L in men or <1.29 mmol/L in women) (OR 2.135, 95%CI 1.786~2.551). Conclusion Obesity and abnormal HDL and LDL are becoming important risk factors for gallstones. The impact of obesity is extremely prominent among young and middle-aged men, and women of childbearing age need to pay special attention to LDL levels.