Glycemic load, glycemic index, and carbohydrate intake in relation to risk of cholecystectomy in women.
OBJECTIVE
High-carbohydrate diets with a high glycemic response may exacerbate the metabolic consequences of the insulin-resistance syndrome. The effect on the incidence of gallstone disease is not clear.


METHODS
We examined the associations between high-carbohydrate diets with a high glycemic response and the risk of cholecystectomy in a cohort of women who were aged from 35 to 61 years in 1984 and had no history of gallstone disease. As part of the Nurses' Health Study, the women reported on questionnaires mailed to them every 2 years both their carbohydrate intake and whether they had undergone cholecystectomy.


RESULTS
During 16 years of follow-up, we ascertained 5771 new cases of cholecystectomy. After adjusting for age and other known or suspected risk factors in a multivariate model, the relative risk for the highest compared with the lowest quintile of dietary carbohydrate was 1.35 (95% CI: 1.17-1.55, P for trend < .0001). The relative risks for the highest compared with the lowest quintile were 1.50 for glycemic load (95% CI: 1.32-1.71, P for trend < .0001) and 1.32 for glycemic index (95% CI: 1.20-1.45, P for trend < .0001). Independent positive associations were also seen for intakes of starch and sucrose.


CONCLUSIONS
Our findings suggest that a higher intake of carbohydrate, dietary glycemic load, and glycemic index may enhance risk of cholecystectomy in women.
Tsai
Chung-Jyi
CJ
Channing Laboratory, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, Massachusetts, USA. hpcjt@channing.harvard.edu
Leitzmann
Michael F
MF
Willett
Walter C
WC
Giovannucci
Edward L
EL
D000328:Adult; D001786:Blood Glucose; D002763:Cholecystectomy / Q000706:statistics & numerical data*; D004040:Dietary Carbohydrates / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D042882:Gallstones / Q000453:epidemiology* / Q000601:surgery; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology*; D015994:Incidence; D008875:Middle Aged; D015999:Multivariate Analysis; D015596:Nutrition Assessment; D011237:Predictive Value of Tests; D012307:Risk Factors; D011795:Surveys and Questionnaires
D001786:Blood Glucose; D004040:Dietary Carbohydrates