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High BMI linked to gallstone disease, particularly among women

Patients with elevated BMI, especially women, were more likely to develop symptomatic gallstone disease than those with low BMI in a recent study.

Researchers evaluated data on 77,679 patients from two prospective studies of the Danish general population. Symptomatic gallstone disease developed in 4,106 patients within the cohort, with follow-up from establishment of the National Danish Patient Registry in January 1977 or patient’s birthday to death, disease occurrence, emigration or the last registry update in May 2011. All participants underwent genotyping for BMI-associated variants FTO(rs9939609), MC4R(rs17782313) and TMEM18(rs6548238), and were assigned a score between 0 and 6 indicating the number of BMI-increasing alleles.

Multivariate analysis showed that patients in the highest BMI quintile (mean BMI 32.5 kg/m2) were at significantly increased risk for symptomatic gallstone disease compared with those in the lowest quintile (mean BMI 20.9 kg/m2) during a mean follow-up of 5.3 years (adjusted HR=2.84; 95% CI, 2.32-3.46). This association was greater among women (aHR=3.36; 95% CI, 2.62-4.31) than men (aHR=1.51; 95% CI, 1.09-2.11).

Risk for disease increased with the number of BMI-increasing alleles, with a 5.2% higher mean BMI for an allele score of 6 compared with patients who scored 0 or 1. This difference was stronger among men (6.1%) than women (4.3%) (P<.001 for all comparisons). Investigators calculated an adjusted HR of 1.43 (95% CI, 0.99-2.05) for symptomatic gallstone disease risk among those with a score of 6 vs. 0-1, and estimated a causal OR of 1.17 (95% CI, 0.99-1.37) for disease with a 1 kg/m2 BMI increase (OR=1.2; 95% CI, 1-1.44 among women; OR=1.02; 95% CI, 0.9-1.16 among men).

“Elevated BMI as measured at baseline, as well as genetically (lifelong and unconfounded) elevated BMI associates with increased risk of symptomatic gallstone disease,” the researchers concluded. “Taken together, this indicates that elevated BMI per se is likely a causal risk factor for symptomatic gallstone disease, which is most pronounced in women. These data re-emphasize obesity as a major cause of human morbidity, and provide additional impetus for lifestyle interventions aimed at weight loss among overweight and obese individuals in the general population.”