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Association between the Framingham steatosis index and gallstone disease in adults: A cross-sectional study based on NHANES
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Qizhen ZHANG1, Sutong LIU1, Lihui ZHANG1, Yijia SONG2, Yajie GUAN2, Minghao LIU1, 3, 4
Journal of Army Medical University | 2026, 48(2) : 191 - 202
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Journal of Army Medical University | 2026, 48(2): 191-202
• Think Tank for Public Health •
Association between the Framingham steatosis index and gallstone disease in adults: A cross-sectional study based on NHANES
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Qizhen ZHANG1, Sutong LIU1, Lihui ZHANG1, Yijia SONG2, Yajie GUAN2, Minghao LIU1, 3, 4
Affiliations
  • 1Diagnostic and Treatment Center for Liver, Spleen and Stomach Diseases, First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, Henan
  • 2First Clinical Medical College, Henan University of Traditional Chinese Medicine, Zhengzhou, Henan
  • 3Henan Provincial Collaborative Innovation Center for Prevention and Treatment of Major Diseases by Chinese and Western Medicine, Zheng zhou, Henan
  • 4Henan Provincial Collaborative Innovation Center for Yu-Yao Whole Industry Chain Research and Development, Zhengzhou, Henan, China
Published: 2026-01-30 doi: 10.16016/j.2097-0927.202510013
Outline
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Objective

To investigate the association between Framingham steatosis index (FSI) and the risk of gallstone disease in order to evaluate its potential as a risk marker and simple screening tool.

Methods

A cross-sectional study was conducted on 5 705 adults subjected from the 2017-2020 cycle of the US National Health and Nutrition Examination Survey (NHANES). A complex sampling-weighted multivariable logistic regression model was employed to assess the association between FSI (treated as both a continuous variable and in quartiles) and gallstone risk. Restricted cubic spline (RCS) and threshold effect analyses were utilized to explore nonlinear relationships. Interaction and subgroup analyses were performed to examine potential effect modifiers, and multiple sensitivity analyses were applied to verify the robustness of the findings.

Results

The fully adjusted logistic regression model showed a significant positive association between FSI and gallstone risk (OR=1.31, 95%CI: 1.20 to 1.44, P<0.001). Compared with the low FSI quartile, the high quartile had a significantly increased risk (OR=3.67, 95%CI: 2.21 to 6.09, P<0.001). Restricted cubic spline analysis suggested a nonlinear relationship between FSI and gallstone disease (P for nonlinear=0.031), with an inflection point at -0.27. Sensitivity analyses confirmed the robustness of the positive association.

Conclusion

Elevated FSI levels are significantly positively correlated with the risk of gallstone disease, suggesting its potential as a convenient metabolic composite indicator in community and clinical settings for the rapid identification of high-risk individuals. Countermeasures It is recommended that public health authorities should consider taking FSI into screening program for adult gallstone risk. Following prospective validation in Chinese populations, its threshold value could be utilized for rapid community-based risk stratification (high-vs low-risk), thereby optimizing the allocation of screening resources. Furthermore, comprehensive guidelines targeting body weight, blood lipids, blood pressure, and blood glucose should be developed and promoted. Strengthening public education and enhancing surveillance should be conducted to achieve the ultimate goals of early warning, precise intervention, and reduction of disease burden for high-risk populations.

Framingham steatosis index  /  cholelithiasis  /  fatty liver  /  cross-sectional studies  /  National Health and Nutrition Examination Survey
张琪振, 刘素彤, 张丽慧, 宋艺佳, 管雅捷, 刘鸣昊. 弗雷明汉脂肪变性指数与成年人胆结石病的关联性分析:一项基于NHANES的横断面研究. 陆军军医大学学报, 2026 , 48 (2) : 191 -202 . DOI: 10.16016/j.2097-0927.202510013
Qizhen ZHANG, Sutong LIU, Lihui ZHANG, Yijia SONG, Yajie GUAN, Minghao LIU. Association between the Framingham steatosis index and gallstone disease in adults: A cross-sectional study based on NHANES[J]. Journal of Army Medical University, 2026 , 48 (2) : 191 -202 . DOI: 10.16016/j.2097-0927.202510013
Year 2026 volume 48 Issue 2
82
32
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Article Info
doi: 10.16016/j.2097-0927.202510013
  • Receive Date:2025-10-10
  • Online Date:2026-10-23
  • Published:2026-01-30
Article Data
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History
  • Received:2025-10-10
  • Revised:2025-12-13
Affiliations
    1Diagnostic and Treatment Center for Liver, Spleen and Stomach Diseases, First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, Henan
    2First Clinical Medical College, Henan University of Traditional Chinese Medicine, Zhengzhou, Henan
    3Henan Provincial Collaborative Innovation Center for Prevention and Treatment of Major Diseases by Chinese and Western Medicine, Zheng zhou, Henan
    4Henan Provincial Collaborative Innovation Center for Yu-Yao Whole Industry Chain Research and Development, Zhengzhou, Henan, China
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表12种不同金属材料的力学参数
科
Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
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属
Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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