title: Gallstones and Risk of Coronary Heart Disease: Prospective Analysis of 270 000 Men and Women From 3 US Cohorts and Meta-Analysis.
abstract: Gallstone disease has been related to cardiovascular risk factors; however, whether presence of gallstones predicts coronary heart disease (CHD) is not well established.
  
  
  
  We followed up 269 142 participants who were free of cancer and cardiovascular disease at baseline from 3 US cohorts: the Nurses' Health Study (112 520 women; 1980-2010), Nurses' Health Study II (112 919 women; 1989-2011), and the Health Professionals Follow-up Study (43 703 men; 1986-2010) and documented 21 265 incident CHD cases. After adjustment for potential confounders, the hazard ratio for the participants with a history of gallstone disease compared with those without was 1.15 (95% confidence interval, 1.10-1.21) in Nurses' Health Study, 1.33 (95% confidence interval, 1.17-1.51) in Nurses' Health Study II, and 1.11 (95% confidence interval, 1.04-1.20) in Health Professionals Follow-up Study. The associations seemed to be stronger in individuals who were not obese, not diabetic, or were normotensive, compared with their counterparts. We identified 4 published prospective studies by searching PUBMED and EMBASE up to October 2015, coupled with our 3 cohorts, involving 842 553 participants and 51 123 incident CHD cases. The results from meta-analysis revealed that a history of gallstone disease was associated with a 23% (15%-33%) increased CHD risk.
  
  
  
  Our findings support that a history of gallstone disease is associated with increased CHD risk, independently of traditional risk factors.
authors.affiliation: From the Department of Nutrition (Y.Z., M.X., Y.L., A.H., E.B.R., F.B.H., L.Q.) and Department of Epidemiology (E.B.R., F.B.H., J.E.M.), Harvard T.H. Chan School of Public Health, Boston, MA; Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China (M.X.); Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (J.W.); Division of Preventive Medicine, Department of Medicine (C.M.A., K.M.R., J.E.M.) and Channing Division of Network Medicine, Department of Medicine (E.B.R., F.B.H., J.E.M.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; and Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (L.Q.).
authors.forename: Yan
authors.initials: Y
authors.lastname: Zheng
authors.affiliation: From the Department of Nutrition (Y.Z., M.X., Y.L., A.H., E.B.R., F.B.H., L.Q.) and Department of Epidemiology (E.B.R., F.B.H., J.E.M.), Harvard T.H. Chan School of Public Health, Boston, MA; Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China (M.X.); Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (J.W.); Division of Preventive Medicine, Department of Medicine (C.M.A., K.M.R., J.E.M.) and Channing Division of Network Medicine, Department of Medicine (E.B.R., F.B.H., J.E.M.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; and Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (L.Q.).
authors.forename: Min
authors.initials: M
authors.lastname: Xu
authors.affiliation: From the Department of Nutrition (Y.Z., M.X., Y.L., A.H., E.B.R., F.B.H., L.Q.) and Department of Epidemiology (E.B.R., F.B.H., J.E.M.), Harvard T.H. Chan School of Public Health, Boston, MA; Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China (M.X.); Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (J.W.); Division of Preventive Medicine, Department of Medicine (C.M.A., K.M.R., J.E.M.) and Channing Division of Network Medicine, Department of Medicine (E.B.R., F.B.H., J.E.M.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; and Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (L.Q.).
authors.forename: Yanping
authors.initials: Y
authors.lastname: Li
authors.affiliation: From the Department of Nutrition (Y.Z., M.X., Y.L., A.H., E.B.R., F.B.H., L.Q.) and Department of Epidemiology (E.B.R., F.B.H., J.E.M.), Harvard T.H. Chan School of Public Health, Boston, MA; Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China (M.X.); Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (J.W.); Division of Preventive Medicine, Department of Medicine (C.M.A., K.M.R., J.E.M.) and Channing Division of Network Medicine, Department of Medicine (E.B.R., F.B.H., J.E.M.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; and Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (L.Q.).
authors.forename: Adela
authors.initials: A
authors.lastname: Hruby
authors.affiliation: From the Department of Nutrition (Y.Z., M.X., Y.L., A.H., E.B.R., F.B.H., L.Q.) and Department of Epidemiology (E.B.R., F.B.H., J.E.M.), Harvard T.H. Chan School of Public Health, Boston, MA; Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China (M.X.); Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (J.W.); Division of Preventive Medicine, Department of Medicine (C.M.A., K.M.R., J.E.M.) and Channing Division of Network Medicine, Department of Medicine (E.B.R., F.B.H., J.E.M.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; and Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (L.Q.).
authors.forename: Eric B
authors.initials: EB
authors.lastname: Rimm
authors.affiliation: From the Department of Nutrition (Y.Z., M.X., Y.L., A.H., E.B.R., F.B.H., L.Q.) and Department of Epidemiology (E.B.R., F.B.H., J.E.M.), Harvard T.H. Chan School of Public Health, Boston, MA; Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China (M.X.); Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (J.W.); Division of Preventive Medicine, Department of Medicine (C.M.A., K.M.R., J.E.M.) and Channing Division of Network Medicine, Department of Medicine (E.B.R., F.B.H., J.E.M.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; and Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (L.Q.).
authors.forename: Frank B
authors.initials: FB
authors.lastname: Hu
authors.affiliation: From the Department of Nutrition (Y.Z., M.X., Y.L., A.H., E.B.R., F.B.H., L.Q.) and Department of Epidemiology (E.B.R., F.B.H., J.E.M.), Harvard T.H. Chan School of Public Health, Boston, MA; Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China (M.X.); Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (J.W.); Division of Preventive Medicine, Department of Medicine (C.M.A., K.M.R., J.E.M.) and Channing Division of Network Medicine, Department of Medicine (E.B.R., F.B.H., J.E.M.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; and Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (L.Q.).
authors.forename: Janine
authors.initials: J
authors.lastname: Wirth
authors.affiliation: From the Department of Nutrition (Y.Z., M.X., Y.L., A.H., E.B.R., F.B.H., L.Q.) and Department of Epidemiology (E.B.R., F.B.H., J.E.M.), Harvard T.H. Chan School of Public Health, Boston, MA; Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China (M.X.); Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (J.W.); Division of Preventive Medicine, Department of Medicine (C.M.A., K.M.R., J.E.M.) and Channing Division of Network Medicine, Department of Medicine (E.B.R., F.B.H., J.E.M.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; and Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (L.Q.).
authors.forename: Christine M
authors.initials: CM
authors.lastname: Albert
authors.affiliation: From the Department of Nutrition (Y.Z., M.X., Y.L., A.H., E.B.R., F.B.H., L.Q.) and Department of Epidemiology (E.B.R., F.B.H., J.E.M.), Harvard T.H. Chan School of Public Health, Boston, MA; Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China (M.X.); Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (J.W.); Division of Preventive Medicine, Department of Medicine (C.M.A., K.M.R., J.E.M.) and Channing Division of Network Medicine, Department of Medicine (E.B.R., F.B.H., J.E.M.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; and Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (L.Q.).
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Rexrode
authors.affiliation: From the Department of Nutrition (Y.Z., M.X., Y.L., A.H., E.B.R., F.B.H., L.Q.) and Department of Epidemiology (E.B.R., F.B.H., J.E.M.), Harvard T.H. Chan School of Public Health, Boston, MA; Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China (M.X.); Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (J.W.); Division of Preventive Medicine, Department of Medicine (C.M.A., K.M.R., J.E.M.) and Channing Division of Network Medicine, Department of Medicine (E.B.R., F.B.H., J.E.M.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; and Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (L.Q.).
authors.forename: JoAnn E
authors.initials: JE
authors.lastname: Manson
authors.affiliation: From the Department of Nutrition (Y.Z., M.X., Y.L., A.H., E.B.R., F.B.H., L.Q.) and Department of Epidemiology (E.B.R., F.B.H., J.E.M.), Harvard T.H. Chan School of Public Health, Boston, MA; Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China (M.X.); Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (J.W.); Division of Preventive Medicine, Department of Medicine (C.M.A., K.M.R., J.E.M.) and Channing Division of Network Medicine, Department of Medicine (E.B.R., F.B.H., J.E.M.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; and Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (L.Q.). lqi1@tulane.edu.
authors.forename: Lu
authors.initials: L
authors.lastname: Qi
mesh_terms: D000328:Adult; D000368:Aged; D003327:Coronary Disease / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D042882:Gallstones / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D014481:United States / Q000453:epidemiology
keywords: adult; bile; cohort study; coronary disease; gallstones