title: Relationship of serum leptin concentration and other measures of adiposity with gallbladder disease.
abstract: Obesity increases the risk of gallstones, especially in women. Most gallbladder disease studies have used body mass index (BMI) as a measure of overall adiposity, although BMI does not distinguish between fat and lean body mass. Central adiposity may also increase gallstone risk, although this is less well studied. Leptin is a peptide whose serum concentration is highly correlated with total body fat mass. We examined the relationship of gallbladder disease with anthropometric measures and serum leptin concentration in a large, national, population-based study. A total of 13,962 adult participants in the Third National Health and Nutrition Examination Survey underwent gallbladder ultrasonography and anthropometric measurements of BMI, body circumferences, and skinfold thicknesses, and a random subgroup of 5,568 had measures of fasting serum leptin concentrations. Gallstone-associated gallbladder disease was defined as ultrasound-documented gallstones or evidence of cholecystectomy. When controlling for BMI and other gallbladder disease risk factors in multivariate analysis, a test for trend for increasing waist-to-hip circumference ratio and risk of gallbladder disease was statistically significant among women (P =.043) and men (P =.007). BMI remained strongly associated with gallbladder disease among women (P <.001), but was unrelated among men (P =.46). Leptin concentration was associated with gallbladder disease in both sexes (P <.001), but not after controlling for BMI and waist-to-hip circumference in either women (P =.29) or men (P =.65). In conclusion, waist-to-hip circumference ratio was related to gallbladder disease among women and men. Serum leptin concentration was not a better predictor of gallbladder disease than anthropometry.
authors.affiliation: Social and Scientific Systems, Inc., Silver Spring, MD 20910-3714, USA. Cruhl@s-3.com
authors.forename: C E
authors.initials: CE
authors.lastname: Ruhl
authors.forename: J E
authors.initials: JE
authors.lastname: Everhart
mesh_terms: D000273:Adipose Tissue / Q000473:pathology*; D000328:Adult; D000368:Aged; D000886:Anthropometry; D001824:Body Constitution; D015992:Body Mass Index; D002769:Cholelithiasis / Q000000981:diagnostic imaging; D005215:Fasting / Q000097:blood; D005260:Female; D005704:Gallbladder / Q000000981:diagnostic imaging; D005705:Gallbladder Diseases / Q000097:blood* / Q000473:pathology*; D006801:Humans; D020738:Leptin / Q000097:blood*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009994:Osmolar Concentration; D012727:Sex Characteristics; D012885:Skinfold Thickness; D014463:Ultrasonography
chemical_list: D020738:Leptin