title: Gallstone disease and obesity: a population-based study on abdominal fat distribution and gender differences.
abstract: BACKGROUND
  Existing evidence suggests the visceral fat is more metabolically active than subcutaneous fat. We aimed to investigate the value of subcutaneous (SAT) and visceral adipose tissue thickness (VAT) for prediction of gallstone disease (GSD) in general population by focus on gender differences and comparison with body mass index (BMI), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR).
  
  
  METHODS
  In this cross-sectional survey, 1,494 subjects (51.4 % men), aged above 50, randomly selected from Golestan Cohort Study residing in Gonbad City, Iran, underwent anthropometric measurements and abdominal ultrasonography.
  
  
  RESULTS
  Prevalence of GSD was 17.8% (95% CI 15.9-19.8). Following adjustment for age and then other potential risk factors, all obesity indices, except for SAT, were associated with GSD in women with the highest odds ratio observed in WHtR (OR 1.52, 95% CI 1.22-1.89). In contrast, WHR was the only associated index in men (OR 1.49, 95% CI 1.08-2.06). The trend of increasing obesity measures across the quartiles with the risk of GSD was significant in subgroups of WHtR and BMI in women and WHR in men. No significant association was found between SAT and GSD in men or women.
  
  
  CONCLUSIONS
  The best anthropometric indicators of the risk of GSD may differ by gender. In men, WHR might be the only preferred index to estimate risk of GSD. WHtR, WHR, VAT and BMI are associated with GSD risk in women, although WHtR might better explain this risk. SAT is the poor indicator for identifying subjects with GSD in both genders.
authors.affiliation: Department of Radiology, Shariati hospital, Tehran University of Medical Sciences. Tehran, Iran.
authors.forename: Amir Reza
authors.initials: AR
authors.lastname: Radmard
authors.affiliation: Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences. Tehran, Iran.
authors.forename: Shahin
authors.initials: S
authors.lastname: Merat
authors.affiliation: Department of Radiology, Shariati hospital, Tehran University of Medical Sciences. Tehran, Iran.
authors.forename: Soheil
authors.initials: S
authors.lastname: Kooraki
authors.affiliation: Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences. Tehran, Iran.
authors.forename: Mahya
authors.initials: M
authors.lastname: Ashraf
authors.affiliation: Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences. Tehran, Iran.
authors.forename: Abbas
authors.initials: A
authors.lastname: Keshtkar
authors.affiliation: Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences. Tehran, Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Sharafkhah
authors.affiliation: Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences. Tehran, Iran.
authors.forename: Elham
authors.initials: E
authors.lastname: Jafari
authors.affiliation: Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences. Tehran, Iran.
authors.forename: Reza
authors.initials: R
authors.lastname: Malekzadeh
authors.affiliation: Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences. Tehran, Iran.
authors.forename: Hossein
authors.initials: H
authors.lastname: Poustchi
mesh_terms: D050153:Abdominal Fat / Q000503:physiopathology*; D050154:Adiposity; D000368:Aged; D015992:Body Mass Index; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D005260:Female; D042882:Gallstones / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D007492:Iran / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D056128:Obesity, Abdominal / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D016017:Odds Ratio; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D049629:Waist-Hip Ratio