素食者胆石病风险分析及其与胆固醇变化的相关研究

Analysis of cholelithiasis risk in vegetarians and correlation with cholesterol changes

目的本研究旨在前瞻性队列研究素食者与非素食者发生症状性胆石病(Gallstone disease,GSD)的风险,并探讨这种相关性是否与胆固醇浓度有关.方法我们前瞻性地随访了1210名参与者,确认了26例新的GSD病例.通过有效的食物频率问卷来评估饮食,GSD招募时测量血液胆固醇水平.应用Cox回归评估饮食对症状性GSD的影响,调整年龄、教育、吸烟、酒精、体育活动、糖尿病、肾病、体重指数、降脂药物和高胆固醇血症.结果与非素食饮食相比,素食饮食与女性发生症状性GSD的风险降低相关(HR=0.52,95%CI=0.28~0.96),但在男性中没有.在女性中,高胆固醇血症的非素食者发生GSD的风险是胆固醇正常的素食者的3.8倍(HR,3.81,95%CI,1.61~9.01).结论素食可以预防GSD,独立于基线高胆固醇血症,非素食饮食和高胆固醇血症可能在增加女性GSD风险方面具有附加效应.

Objective This study aimed to investigate prospectively the risk of incident symptomatic cholelithiasis(GSD)in vegetarians versus non vegetarians in a prospective cohort and to investigate whether this association is related to cholesterol concentration.Methods We prospectively followed 1210 participants and identified 26 new GSD cases.Diet was assessed by a validated food frequency questionnaire,and blood cholesterol levels were measured at GSD recruitment.Cox regression was applied to assess the effect of diet on symptomatic GSD,adjusting for age,education,smoking,alcohol,physical activity,diabetes,renal disease,body mass index,lipid-lowering medications,and hypercholesterolemia.Results Compared with a non vegetarian diet,a vegetarian diet was associated with a reduced risk of developing symptomatic GSD in women(HR=0.52,95%CI=0.28~0.96),but not in men.Among women,non vegetarians with hypercholesterolemia had a 3.8-fold greater risk of developing GSD than vegetarians with normal cholesterol(HR,3.81,95%CI,1.61~9.01).Conclusions A vegetarian diet protects against GSD independent of baseline hypercholesterolemia,and a non vegetarian diet and hypercholesterolemia may have additive effects in increasing GSD risk in women.