title: Prospective study of abdominal adiposity and gallstone disease in US men.
abstract: BACKGROUND
  Obesity is an established risk factor for gallstones, but whether abdominal adiposity contributes independently to the risk, particularly in men, remains unclear.
  
  
  OBJECTIVE
  The purpose of the study was to examine the associations of abdominal circumference and waist-to-hip ratio, as measures of abdominal adiposity, with the risk of symptomatic gallstone disease in men.
  
  
  METHODS
  We prospectively studied measures of abdominal obesity in relation to the incidence of symptomatic gallstone disease in a cohort of 29 847 men who were free of prior gallstone disease and who provided complete data on waist and hip circumferences. Data on weight, height, and waist and hip circumferences were collected in 1986 and in 1987 through self-administered questionnaires. As part of the Health Professionals Follow-Up Study, men reported newly diagnosed symptomatic gallstone disease on questionnaires mailed to them every 2 y.
  
  
  RESULTS
  We documented 1117 new cases of symptomatic gallstone disease during 264 185 person-years of follow-up. After adjustment for body mass index and other known or suspected risk factors for gallstones, men with a height-adjusted waist circumference > or = 102.6 cm (40.4 in) had a relative risk of 2.29 (95% CI: 1.69, 3.11; P for trend < 0.001) compared with men with a height-adjusted waist circumference < 86.4 cm (34 in). Men with a waist-to-hip ratio > or = 0.99 had a multivariate relative risk of 1.78 (1.38, 2.28; P for trend < 0.001) compared with men with a waist-to-hip ratio < 0.89.
  
  
  CONCLUSIONS
  Our data suggest the presence of a significant association between abdominal adiposity and the incidence of symptomatic gallstone disease. As measures of abdominal adiposity, abdominal circumference and waist-to-hip ratio predict the risk of developing gallstones independently of body mass index.
authors.affiliation: Channing Laboratory, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, USA. hpcjt@channing.harvard.edu
authors.forename: Chung-Jyi
authors.initials: CJ
authors.lastname: Tsai
authors.forename: Michael F
authors.initials: MF
authors.lastname: Leitzmann
authors.forename: Walter C
authors.initials: WC
authors.lastname: Willett
authors.forename: Edward L
authors.initials: EL
authors.lastname: Giovannucci
mesh_terms: D000005:Abdomen; D000273:Adipose Tissue / Q000033:anatomy & histology* / Q000378:metabolism*; D000328:Adult; D000368:Aged; D000886:Anthropometry; D001824:Body Constitution / Q000502:physiology*; D015992:Body Mass Index; D015331:Cohort Studies; D005500:Follow-Up Studies; D042882:Gallstones / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000150:complications* / Q000378:metabolism; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology