Article(id=1311349803125137716, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1311349802038821144, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202512392, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1766505600000, receivedDateStr=2025-12-24, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1790579756766, onlineDateStr=2026-09-28, pubDate=1783612800000, pubDateStr=2026-07-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1790579756766, onlineIssueDateStr=2026-09-28, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1790579756766, creator=13701087609, updateTime=1790579756766, updator=13701087609, issue=Issue{id=1311349802038821144, tenantId=1146029695717560320, journalId=1227665162245664772, year='2026', volume='53', issue='13', pageStart='2305', pageEnd='2496', issueExtLink='null', onlineDate='null', pubDate='1783612800000', pubDateStr='2026-07-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1790579756507, creator='13701087609', updateTime=1790588376143, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1311385955492258162, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1311349802038821144, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1311385955496452467, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1311349802038821144, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=2305, endPage=2311, ext={EN=ArticleExt(id=1311349803318075701, articleId=1311349803125137716, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Association between visceral fat accumulation indicators and gallstone disease risk in the Dong ethnic population of Guizhou Province, columnId=1240413921954295836, journalTitle=Modern Preventive Medicine, columnName=Epidemiology and Statistical Methods, runingTitle=null, highlight=null, articleAbstract=
Objective

To explore the association between visceral fat accumulation indicators and gallstone risk in the Dong population of Guizhou.

Methods

A total of 6 375 permanent residents aged 30-79 years were enrolled from the Southwest China Natural Population Cohort of Minority Communities. Logistic regression, subgroup analysis and restricted cubic spline analysis were used to examine the associations of metabolic score for visceral fat (METS-VF), lipid accumulation product(LAP), visceral adiposity index (VAI), and waist circumference (WC) with gallstones.

Results

The gallstone detection rate was 10.9% in the Dong population of Guizhou, higher in females (12.2%) than in males (8.4%). Gallstone patients had higher METS-VF, LAP, VAI, and WC. Compared with Q1, Q4 levels of METS-VF (OR=2.206, 95% CI:1.704-2.856), LAP (OR=2.280, 95% CI:1.789-2.905), VAI (OR=1.674, 95% CI:1.323-2.118) and WC (OR=2.046, 95% CI:1.608-2.603) were all positively associated with gallstone risk. Subgroup analyses showed significant associations only in females (P<0.05), with an interaction between gender and METS-VF (P for interaction =0.007). In the age subgroups, VAI was significant only in participants aged <60 years, while the other indicators were significant in both age groups (P<0.05). Medium-to-high levels of all indicators were positively associated with gallstone risk in those consuming glutinous rice or oil tea (P<0.05). Dose-response analyses showed linear associations of METS-VF and WC with gallstone risk, and nonlinear associations of LAP and VAI with gallstone risk.

Conclusion

Visceral fat accumulation indicators are positively associated with gallstone risk in the Dong ethnic population of Guizhou Province. This association exhibits female specificity and is more pronounced among individuals who consume glutinous rice or oil tea. Public health strategies should prioritize visceral fat management in Dong women, utilize these indicators as supplementary tools for early screening, and develop targeted intervention strategies for high-risk populations to reduce the disease burden of gallstones.

, authors=Lin-fei HUANG, Ting-lian LEI, Yu-xin ZHANG, Tong-hai LONG, Zhu-tiao CEN, Feng HONG, authorsList=Lin-fei HUANG, Ting-lian LEI, Yu-xin ZHANG, Tong-hai LONG, Zhu-tiao CEN, Feng HONG, authorCompany=null, correspAuthors=Feng HONG, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1311349804492480830, articleId=1311349803125137716, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=内脏脂肪积累指标与贵州省侗族人群胆结石患病风险的相关性研究, columnId=1228016567632462653, journalTitle=现代预防医学, columnName=流行病与统计方法, runingTitle=null, highlight=null, articleAbstract=
目的

探讨贵州省侗族人群内脏脂肪积累指标与胆结石患病风险的关联。

方法

基于“西南区域少数民族聚集地世居自然人群队列研究”基线数据,纳入贵州省6 375名30~79岁侗族常住居民。使用logistic回归、亚组分析及限制性立方样条分析内脏脂肪代谢评分(metabolic score for visceral fat,METS-VF)、脂质积累产物(lipid accumulation product,LAP)、内脏脂肪指数(visceral adiposity index,VAI)、腰围与胆结石间的关联。

结果

贵州省侗族人群胆结石检出率为10.9%,女性为12.2%,高于男性的8.4%,胆结石患者METS-VF、LAP、VAI和腰围更高。与Q1水平相比,Q4水平METS-VF、LAP、VAI和腰围均与胆结石患病风险正相关(OR=2.206,95%CI:1.704~2.856;OR=2.280,95%CI:1.789~2.905;OR=1.674,95%CI:1.323~2.118;OR=2.046,95%CI:1.608~2.603)。亚组分析显示各指标仅在女性中与胆结石显著相关(P<0.05);性别与METS-VF存在交互作用(P=0.007);年龄亚组中,VAI仅在<60岁组显著,其余指标在两年龄组均显著(P<0.05);食用糯米/油茶者各指标中高水平组均与胆结石风险正相关(P<0.05)。剂量反应关系表明METS-VF、腰围与胆结石呈线性关系,LAP、VAI与胆结石呈非线性关系。

结论

内脏脂肪积累指标与贵州省侗族人群胆结石患病风险正相关,关联具有女性特异性,且在食用糯米/油茶人群中更为显著。公共卫生策略应优先聚焦于贵州省侗族女性的内脏脂肪管理,并将相关指标作为胆结石早期筛查的补充工具,并针对高风险人群制定精准干预策略,以降低胆结石的疾病负担。

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黄琳斐(2001—),女,硕士在读,研究方向:环境与人群毒理学

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洪峰,E-mail:
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Cureus,2024, 16(12): e76560., articleTitle=Non-Surgical management of gallstones during pregnancy: a clinical case report, refAbstract=null), Reference(id=1311349815682883987, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311349803125137716, doi=null, pmid=null, pmcid=null, year=2024, volume=13, issue=1, pageStart=78, pageEnd=null, url=null, language=null, rfNumber=[28], rfOrder=29, authorNames=Hirata Y, Sakuma Y, Ogiso H, journalName=Biomedicines, refType=null, unstructuredReference=Hirata Y, Sakuma Y, Ogiso H, et al. Targeted plasma bile acid metabolomic analysis in metabolic Dysfunction-Associated steatohepatitis and alcoholic hepatitis[J]. Biomedicines, 2024, 13(1): 78., articleTitle=Targeted plasma bile acid metabolomic analysis in metabolic Dysfunction-Associated steatohepatitis and alcoholic hepatitis, refAbstract=null), Reference(id=1311349815754187156, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311349803125137716, doi=null, pmid=null, pmcid=null, year=2024, volume=53, issue=2, pageStart=173, pageEnd=179, url=null, language=null, rfNumber=[29], rfOrder=30, authorNames=史佳琪, 房红芸, 琚腊红, journalName=卫生研究, refType=null, unstructuredReference=史佳琪,房红芸,琚腊红,等. 2002-2015年中国60岁及以上老年人低体重发生率及变化趋势[J].卫生研究,2024,53(2):173-179., articleTitle=2002-2015年中国60岁及以上老年人低体重发生率及变化趋势, refAbstract=null), Reference(id=1311349815833878933, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311349803125137716, doi=null, pmid=null, pmcid=null, year=2024, volume=53, issue=2, pageStart=173, pageEnd=179, url=null, language=null, rfNumber=[29], rfOrder=31, authorNames=Shi JQ, Fang HY, Ju LH, journalName=Journal of Hygiene Research, refType=null, unstructuredReference=Shi JQ, Fang HY, Ju LH, et al. Prevalence and trends of low body weight among elderly population aged 60 years and above in China in 2002-2015[J]. Journal of Hygiene Research, 2024, 53(2): 173-179. (In Chinese), articleTitle=Prevalence and trends of low body weight among elderly population aged 60 years and above in China in 2002-2015, refAbstract=null), Reference(id=1311349815913570710, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311349803125137716, doi=null, pmid=null, pmcid=null, year=2025, volume=17, issue=1, pageStart=292, pageEnd=null, url=null, language=null, rfNumber=[30], rfOrder=32, authorNames=Dutta B, Tripathy A, Archana PR, journalName=Diabetology & Metabolic Syndrome, refType=null, unstructuredReference=Dutta B, Tripathy A, Archana PR, et al. Unraveling the complexities of diet induced obesity and glucolipid dysfunction in metabolic syndrome[J]. Diabetology & Metabolic Syndrome, 2025, 17(1): 292., articleTitle=Unraveling the complexities of diet induced obesity and glucolipid dysfunction in metabolic syndrome, refAbstract=null), Reference(id=1311349815984873879, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311349803125137716, doi=null, pmid=null, pmcid=null, year=2024, volume=25, issue=10, pageStart=5488, pageEnd=null, url=null, language=null, rfNumber=[31], rfOrder=33, authorNames=Overnutrition JJ, journalName=International Journal of Molecular Sciences, refType=null, unstructuredReference=Overnutrition JJ. Hyperinsulinemia and ectopic fat: it is time for a paradigm shift in the management of type 2 diabetes[J]. International Journal of Molecular Sciences, 2024, 25(10): 5488., articleTitle=Hyperinsulinemia and ectopic fat: it is time for a paradigm shift in the management of type 2 diabetes, refAbstract=null)], funds=[Fund(id=1311349811647963507, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311349803125137716, awardId=2017YFC0907301, language=CN, fundingSource=国家重点研发计划课题(2017YFC0907301), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1311349804702196031, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311349803125137716, xref=null, ext=[AuthorCompanyExt(id=1311349804714778944, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311349803125137716, companyId=1311349804702196031, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=School of Public Health and Health Sciences, Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, Guizhou 561113, China), AuthorCompanyExt(id=1311349804723167553, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311349803125137716, companyId=1311349804702196031, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=贵州医科大学公共卫生与健康学院,环境污染与疾病监控教育部重点实验室,贵州 贵阳 561113)])], figs=[ArticleFig(id=1311349809064272232, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311349803125137716, language=EN, label=Figure 1, caption=The detection rate of gallstones across quartiles of METS-VF, LAP, VAI and WC, figureFileSmall=8qavhRXL94BxgHXC2mH64A==, figureFileBig=AIqlSGVp32yno7DSg6P9Cg==, tableContent=null), ArticleFig(id=1311349809156546921, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311349803125137716, language=CN, label=图1, caption=METS-VF、LAP、VAI和腰围各四分位组中胆结石检出率

注:WC为腰围。

, figureFileSmall=8qavhRXL94BxgHXC2mH64A==, figureFileBig=AIqlSGVp32yno7DSg6P9Cg==, tableContent=null), ArticleFig(id=1311349810951709035, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311349803125137716, language=EN, label=Figure 2, caption=Subgroup analysis, figureFileSmall=w0CujpkTcp9oxsYGyDn7hg==, figureFileBig=T0n018KHYZ1J2rhpOoYYhA==, tableContent=null), ArticleFig(id=1311349811039789420, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311349803125137716, language=CN, label=图2, caption=亚组分析

注:*P<0.05,**P<0.001;调整性别、年龄、婚姻状况、教育水平、吸烟、饮酒、饮茶、喝饮料、糯米、油茶、高血压、糖尿病;WC为腰围。

, figureFileSmall=w0CujpkTcp9oxsYGyDn7hg==, figureFileBig=T0n018KHYZ1J2rhpOoYYhA==, tableContent=null), ArticleFig(id=1311349811115286893, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311349803125137716, language=EN, label=Figure 3, caption=Dose-response relationship between visceral fat accumulation indicators and gallstones, figureFileSmall=i8+7lT52/gdmjDAJUwn60g==, figureFileBig=xNtQOvdXmOU4XFp1KawAzg==, tableContent=null), ArticleFig(id=1311349811194978670, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311349803125137716, language=CN, label=图3, caption=内脏脂肪积累指标与胆结石的剂量反应关系图

注:调整年龄、性别、婚姻状况、教育水平、吸烟、饮酒、饮茶、喝饮料、糯米、油茶、高血压、糖尿病;图A为METS-VF与胆结石的剂量反应关系;图B为LAP与胆结石的剂量反应关系;图C为VAI与胆结石的剂量反应关系;图D为腰围与胆结石的剂量反应关系。

, figureFileSmall=i8+7lT52/gdmjDAJUwn60g==, figureFileBig=xNtQOvdXmOU4XFp1KawAzg==, tableContent=null), ArticleFig(id=1311349811270476143, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311349803125137716, language=EN, label=Table 1, caption=

Basic information of participants [M (P25, P75), n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
变量总人群(n=6 375)胆结石(n=693)非胆结石(n=5 682)χ2/Z值P值
年龄(岁)52.5(45.4,61.3)54.3(47.1,62.5)52.3(45.1,61.1)-4.222<0.001
性别21.496<0.001
男2 274(35.7)192(27.7)2 082(36.6)
女4 101(64.3)501(72.3)3 600(63.4)
婚姻状态1.6640.435
已婚/同居5 644(88.5)607(87.6)5 037(88.6)
离异/分居/丧偶689(10.8)83(12.0)606(10.7)
未婚42(0.7)3(0.4)39(0.7)
教育水平3.8030.149
小学及以下4 076(63.9)433(62.5)3 643(64.1)
初/高中1 601(25.1)169(24.4)1 432(25.2)
大学及以上698(11.0)91(13.1)607(10.7)
BMI(kg/m2)27.616<0.001
<18.5291(4.6)20(2.9)271(4.8)
18.5~23.93 095(48.6)288(41.6)2 807(49.4)
24~27.92 234(35.0)276(39.8)1 958(34.4)
≥28755(11.8)109(15.7)646(11.4)
吸烟15.0480.001
否5 009(78.6)584(84.3)4 425(77.9)
是1 103(17.3)87(12.5)1 016(17.9)
已戒烟263(4.1)22(3.2)241(4.2)
饮酒13.946<0.001
否5 610(88.0)640(92.4)4 970(87.5)
是765(12.0)53(7.6)712(12.5)
饮茶0.1720.679
否5 506(86.4)595(85.9)4 911(86.4)
是869(13.6)98(14.1)771(13.6)
喝饮料0.3010.583
否6 198(97.2)676(97.5)5 522(97.2)
是177(2.8)17(2.5)160(2.8)
糯米4.2220.040
否818(12.8)106(15.3)712(12.5)
是5 557(87.2)587(84.7)4 970(87.5)
油茶8.6900.003
否2 235(35.1)208(30.0)2 027(35.7)
是4 140(64.9)485(70.0)3 655(64.3)
高血压4.4260.035
否5 226(82.0)548(79.1)4 678(82.3)
是1 149(18.0)145(20.9)1 004(17.7)
糖尿病2.8180.093
否6 103(95.7)655(94.5)5 448(95.9)
是272(4.3)38(5.5)234(4.1)
METS-VF6.5(6.0,6.9)6.7(6.2,7.0)6.5(6.0,6.9)-6.595<0.001
LAP33.2(17.5,58.6)41.9(23.0,72.6)32.3(16.9,56.7)-7.052<0.001
VAI1.7(1.1,2.9)2.0(1.2,3.5)1.7(1.0,2.8)-5.983<0.001
腰围(cm)83.0(75.4,90.0)85.1(78.0,91.6)82.5(75.0,89.5)-6.397<0.001
), ArticleFig(id=1311349811362750832, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311349803125137716, language=CN, label=表1, caption=

研究对象基本信息[M(P25,P75),n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
变量总人群(n=6 375)胆结石(n=693)非胆结石(n=5 682)χ2/Z值P值
年龄(岁)52.5(45.4,61.3)54.3(47.1,62.5)52.3(45.1,61.1)-4.222<0.001
性别21.496<0.001
男2 274(35.7)192(27.7)2 082(36.6)
女4 101(64.3)501(72.3)3 600(63.4)
婚姻状态1.6640.435
已婚/同居5 644(88.5)607(87.6)5 037(88.6)
离异/分居/丧偶689(10.8)83(12.0)606(10.7)
未婚42(0.7)3(0.4)39(0.7)
教育水平3.8030.149
小学及以下4 076(63.9)433(62.5)3 643(64.1)
初/高中1 601(25.1)169(24.4)1 432(25.2)
大学及以上698(11.0)91(13.1)607(10.7)
BMI(kg/m2)27.616<0.001
<18.5291(4.6)20(2.9)271(4.8)
18.5~23.93 095(48.6)288(41.6)2 807(49.4)
24~27.92 234(35.0)276(39.8)1 958(34.4)
≥28755(11.8)109(15.7)646(11.4)
吸烟15.0480.001
否5 009(78.6)584(84.3)4 425(77.9)
是1 103(17.3)87(12.5)1 016(17.9)
已戒烟263(4.1)22(3.2)241(4.2)
饮酒13.946<0.001
否5 610(88.0)640(92.4)4 970(87.5)
是765(12.0)53(7.6)712(12.5)
饮茶0.1720.679
否5 506(86.4)595(85.9)4 911(86.4)
是869(13.6)98(14.1)771(13.6)
喝饮料0.3010.583
否6 198(97.2)676(97.5)5 522(97.2)
是177(2.8)17(2.5)160(2.8)
糯米4.2220.040
否818(12.8)106(15.3)712(12.5)
是5 557(87.2)587(84.7)4 970(87.5)
油茶8.6900.003
否2 235(35.1)208(30.0)2 027(35.7)
是4 140(64.9)485(70.0)3 655(64.3)
高血压4.4260.035
否5 226(82.0)548(79.1)4 678(82.3)
是1 149(18.0)145(20.9)1 004(17.7)
糖尿病2.8180.093
否6 103(95.7)655(94.5)5 448(95.9)
是272(4.3)38(5.5)234(4.1)
METS-VF6.5(6.0,6.9)6.7(6.2,7.0)6.5(6.0,6.9)-6.595<0.001
LAP33.2(17.5,58.6)41.9(23.0,72.6)32.3(16.9,56.7)-7.052<0.001
VAI1.7(1.1,2.9)2.0(1.2,3.5)1.7(1.0,2.8)-5.983<0.001
腰围(cm)83.0(75.4,90.0)85.1(78.0,91.6)82.5(75.0,89.5)-6.397<0.001
), ArticleFig(id=1311349811455025521, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311349803125137716, language=EN, label=Table 2, caption=

Logistic regression analysis between METS-VF, LAP, VAI, WC and gallstones

, figureFileSmall=null, figureFileBig=null, tableContent=
变量模型1模型2
OR(95%CI)P值OR(95%CI)P值
METS-VF
Q1(≤6.0)1.0001.000
Q2(6.1~6.5)1.504(1.171~1.932)0.0011.478(1.148~1.902)0.002
Q3(6.6~6.9)1.762(1.380~2.249)<0.0011.740(1.355~2.234)<0.001
Q4(≥7.0)2.178(1.718~2.761)<0.0012.206(1.704~2.856)<0.001
P for trend<0.001<0.001
LAP
Q1(≤17.6)1.0001.000
Q2(17.7~33.2)1.550(1.205~1.993)0.0011.458(1.131~1.880)0.004
Q3(33.3~58.8)1.666(1.299~2.136)<0.0011.515(1.177~1.951)0.001
Q4(≥58.9)2.430(1.918~3.077)<0.0012.280(1.789~2.905)<0.001
P for trend<0.001<0.001
VAI
Q1(≤1.1)1.0001.000
Q2(1.2~1.7)1.234(0.965~1.576)0.0931.136(0.886~1.457)0.314
Q3(1.8~2.9)1.542(1.218~1.952)<0.0011.392(1.095~1.770)0.007
Q4(≥3.0)1.844(1.465~2.320)<0.0011.674(1.323~2.118)<0.001
P for trend<0.001<0.001
腰围
Q1(≤75.4)1.0001.000
Q2(75.5~83.0)1.134(0.885~1.453)0.3211.142(0.890~1.467)0.297
Q3(83.1~90.0)1.694(1.341~2.139)<0.0011.734(1.368~2.197)<0.001
Q4(≥90.1)1.969(1.560~2.485)<0.0012.046(1.608~2.603)<0.001
P for trend<0.001<0.001
), ArticleFig(id=1311349811543105906, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311349803125137716, language=CN, label=表2, caption=

METS-VF、LAP、VAI和腰围与胆结石的logistic回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量模型1模型2
OR(95%CI)P值OR(95%CI)P值
METS-VF
Q1(≤6.0)1.0001.000
Q2(6.1~6.5)1.504(1.171~1.932)0.0011.478(1.148~1.902)0.002
Q3(6.6~6.9)1.762(1.380~2.249)<0.0011.740(1.355~2.234)<0.001
Q4(≥7.0)2.178(1.718~2.761)<0.0012.206(1.704~2.856)<0.001
P for trend<0.001<0.001
LAP
Q1(≤17.6)1.0001.000
Q2(17.7~33.2)1.550(1.205~1.993)0.0011.458(1.131~1.880)0.004
Q3(33.3~58.8)1.666(1.299~2.136)<0.0011.515(1.177~1.951)0.001
Q4(≥58.9)2.430(1.918~3.077)<0.0012.280(1.789~2.905)<0.001
P for trend<0.001<0.001
VAI
Q1(≤1.1)1.0001.000
Q2(1.2~1.7)1.234(0.965~1.576)0.0931.136(0.886~1.457)0.314
Q3(1.8~2.9)1.542(1.218~1.952)<0.0011.392(1.095~1.770)0.007
Q4(≥3.0)1.844(1.465~2.320)<0.0011.674(1.323~2.118)<0.001
P for trend<0.001<0.001
腰围
Q1(≤75.4)1.0001.000
Q2(75.5~83.0)1.134(0.885~1.453)0.3211.142(0.890~1.467)0.297
Q3(83.1~90.0)1.694(1.341~2.139)<0.0011.734(1.368~2.197)<0.001
Q4(≥90.1)1.969(1.560~2.485)<0.0012.046(1.608~2.603)<0.001
P for trend<0.001<0.001
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内脏脂肪积累指标与贵州省侗族人群胆结石患病风险的相关性研究
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黄琳斐 , 雷廷恋 , 张宇馨 , 龙同海 , 岑柱条 , 洪峰
现代预防医学 | 流行病与统计方法 2026,53(13): 2305-2311
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现代预防医学 |流行病与统计方法 2026 , 53 (13) : 2305 -2311
内脏脂肪积累指标与贵州省侗族人群胆结石患病风险的相关性研究
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黄琳斐, 雷廷恋, 张宇馨, 龙同海, 岑柱条, 洪峰
作者信息
  • 贵州医科大学公共卫生与健康学院,环境污染与疾病监控教育部重点实验室,贵州 贵阳 561113
通讯作者:
洪峰,E-mail:
作者简介:

黄琳斐(2001—),女,硕士在读,研究方向:环境与人群毒理学

Association between visceral fat accumulation indicators and gallstone disease risk in the Dong ethnic population of Guizhou Province
Lin-fei HUANG, Ting-lian LEI, Yu-xin ZHANG, Tong-hai LONG, Zhu-tiao CEN, Feng HONG
Affiliations
  • School of Public Health and Health Sciences, Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, Guizhou 561113, China
出版时间: 2026-07-10 doi: 10.20043/j.cnki.MPM.202512392
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目的

探讨贵州省侗族人群内脏脂肪积累指标与胆结石患病风险的关联。

方法

基于“西南区域少数民族聚集地世居自然人群队列研究”基线数据,纳入贵州省6 375名30~79岁侗族常住居民。使用logistic回归、亚组分析及限制性立方样条分析内脏脂肪代谢评分(metabolic score for visceral fat,METS-VF)、脂质积累产物(lipid accumulation product,LAP)、内脏脂肪指数(visceral adiposity index,VAI)、腰围与胆结石间的关联。

结果

贵州省侗族人群胆结石检出率为10.9%,女性为12.2%,高于男性的8.4%,胆结石患者METS-VF、LAP、VAI和腰围更高。与Q1水平相比,Q4水平METS-VF、LAP、VAI和腰围均与胆结石患病风险正相关(OR=2.206,95%CI:1.704~2.856;OR=2.280,95%CI:1.789~2.905;OR=1.674,95%CI:1.323~2.118;OR=2.046,95%CI:1.608~2.603)。亚组分析显示各指标仅在女性中与胆结石显著相关(P<0.05);性别与METS-VF存在交互作用(P=0.007);年龄亚组中,VAI仅在<60岁组显著,其余指标在两年龄组均显著(P<0.05);食用糯米/油茶者各指标中高水平组均与胆结石风险正相关(P<0.05)。剂量反应关系表明METS-VF、腰围与胆结石呈线性关系,LAP、VAI与胆结石呈非线性关系。

结论

内脏脂肪积累指标与贵州省侗族人群胆结石患病风险正相关,关联具有女性特异性,且在食用糯米/油茶人群中更为显著。公共卫生策略应优先聚焦于贵州省侗族女性的内脏脂肪管理,并将相关指标作为胆结石早期筛查的补充工具,并针对高风险人群制定精准干预策略,以降低胆结石的疾病负担。

胆结石  /  内脏脂肪积累  /  横断面研究  /  少数民族
Objective

To explore the association between visceral fat accumulation indicators and gallstone risk in the Dong population of Guizhou.

Methods

A total of 6 375 permanent residents aged 30-79 years were enrolled from the Southwest China Natural Population Cohort of Minority Communities. Logistic regression, subgroup analysis and restricted cubic spline analysis were used to examine the associations of metabolic score for visceral fat (METS-VF), lipid accumulation product(LAP), visceral adiposity index (VAI), and waist circumference (WC) with gallstones.

Results

The gallstone detection rate was 10.9% in the Dong population of Guizhou, higher in females (12.2%) than in males (8.4%). Gallstone patients had higher METS-VF, LAP, VAI, and WC. Compared with Q1, Q4 levels of METS-VF (OR=2.206, 95% CI:1.704-2.856), LAP (OR=2.280, 95% CI:1.789-2.905), VAI (OR=1.674, 95% CI:1.323-2.118) and WC (OR=2.046, 95% CI:1.608-2.603) were all positively associated with gallstone risk. Subgroup analyses showed significant associations only in females (P<0.05), with an interaction between gender and METS-VF (P for interaction =0.007). In the age subgroups, VAI was significant only in participants aged <60 years, while the other indicators were significant in both age groups (P<0.05). Medium-to-high levels of all indicators were positively associated with gallstone risk in those consuming glutinous rice or oil tea (P<0.05). Dose-response analyses showed linear associations of METS-VF and WC with gallstone risk, and nonlinear associations of LAP and VAI with gallstone risk.

Conclusion

Visceral fat accumulation indicators are positively associated with gallstone risk in the Dong ethnic population of Guizhou Province. This association exhibits female specificity and is more pronounced among individuals who consume glutinous rice or oil tea. Public health strategies should prioritize visceral fat management in Dong women, utilize these indicators as supplementary tools for early screening, and develop targeted intervention strategies for high-risk populations to reduce the disease burden of gallstones.

Gallstones  /  Visceral fat accumulation  /  Cross-sectional study  /  Ethnic minorities
黄琳斐, 雷廷恋, 张宇馨, 龙同海, 岑柱条, 洪峰. 内脏脂肪积累指标与贵州省侗族人群胆结石患病风险的相关性研究. 现代预防医学, 2026 , 53 (13) : 2305 -2311 . DOI: 10.20043/j.cnki.MPM.202512392
Lin-fei HUANG, Ting-lian LEI, Yu-xin ZHANG, Tong-hai LONG, Zhu-tiao CEN, Feng HONG. Association between visceral fat accumulation indicators and gallstone disease risk in the Dong ethnic population of Guizhou Province[J]. Modern Preventive Medicine, 2026 , 53 (13) : 2305 -2311 . DOI: 10.20043/j.cnki.MPM.202512392
胆结石(gallstone)是常见的消化系统疾病,指胆管系统产生结石,其病因复杂,发病率高,并发症多。胆结石全球患病率为10%~20%[1],在中国约为7%~10%且持续上升[2]。胆结石发生与年龄、性别、肥胖、血脂、饮食、遗传等相关[3-4],其中肥胖是关键危险因素,可通过胰岛素抵抗及代谢紊乱促进胆结石形成[5]。肥胖的核心特征是内脏脂肪积累,其危害大于皮下脂肪。而体质量指数(body mass index,BMI)等传统指标难以区分脂肪分布,腰围虽可评估中心性肥胖,但会受BMI影响[6]。为此,内脏脂肪代谢评分(metabolic score for visceral fat,METS-VF)、脂质积累产物(lipid accumulation product,LAP)和内脏脂肪指数(visceral adiposity index,VAI)等被提出以精确评估内脏脂肪积累[7-9],且已证实与糖尿病等多种代谢疾病相关[10-12],但与胆结石的关联研究较少,且多基于欧美人群,针对特定少数民族的研究仍有限。侗族为贵州世居少数民族,常食用糯米、油茶等高碳水、高油脂饮食,其独特的饮食及生活方式可能影响内脏脂肪积累状态与胆结石患病风险。贵州省侗族人群胆结石检出率为12.0%[13],高于全国平均水平。因此明确内脏脂肪积累指标与侗族人群胆结石的关联,并探究其在人口学亚组及饮食习惯亚组中的差异,弥补该领域针对侗族人群研究的不足,为制定精准预防策略提供科学依据,以降低胆结石发病率、减轻疾病负担、提升民族健康水平。为此,本研究基于“西南区域少数民族聚集地世居自然人群队列研究”,分析贵州省30~79岁世居侗族人群METS-VF、LAP、VAI和腰围与胆结石的关联,探讨其在评估该人群胆结石风险中的价值,以期为该地区人群提供更具针对性的风险评估工具和预防依据。
本研究基于“西南区域少数民族聚集地世居自然人群队列研究”基线数据,于2018年5月—2019年9月纳入贵州省黔东南苗族侗族自治州7 239名30~79岁侗族常住居民,排除数据缺失、禁食<8 h、胆囊切除者后,最终6 375人纳入分析。本研究经四川大学华西医院医学伦理委员会(K2016038)和贵州医科大学附属医院医学伦理委员会(2018[094])批准,所有参与者均签署知情同意书。
采用电子问卷面对面访谈并录音质控,收集研究对象基本信息、生活习惯等。体格检查包括身高(height)、体重(weight)等。血液生化指标包括总胆固醇、甘油三酯、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)、空腹血糖等。腹部B超由医生使用便携式B超仪进行检查。
婚姻状态分为已婚/同居、离异/分居/丧偶、未婚;教育程度分为小学及以下、初中及高中、大学及以上;BMI(kg/m2)分为<18.5 kg/m2、18.5 kg/m2~23.9 kg/m2、24 kg/m2~27.9 kg/m2、≥28 kg/m2;吸烟为累积吸烟>100支,戒烟为戒烟≥半年;饮酒/饮茶/喝饮料为每周饮用并持续半年以上;糯米/油茶食用情况为研究对象自我报告过去一年是否食用;高血压/糖尿病为研究对象自我报告;胆结石诊断标准为胆囊或胆管内强回声团,伴清晰声影,可随体位移动[14]。
METS-VF基于腰围身高比(waist-to-height ratio,WHtR)、胰岛素抵抗代谢评分(metabolic score for insulin resistance,METS-IR)、年龄和性别构建(男性性别值=1,女性性别值=0)[7];LAP基于腰围和甘油三酯构建[8];VAI基于腰围、BMI、甘油三酯和HDL-C构建[9],各指标计算公式如下:
其中,WC为腰围,FBG为空腹血糖,TG为甘油三酯。
使用IBM SPSS 25.0和R 4.3.2进行统计分析。非正态分布连续型变量以中位数和四分位数间距[M(P25,P75)]描述,组间比较采用Mann-Whitney U检验;分类变量以频数(n)和构成比(%)描述,组间比较采用χ2检验。将各内脏脂肪积累指标按四分位数分组,以最低四分位数(Q1)为参照,使用logistic回归分析各指标与胆结石间的关联,计算比值比(odds ratio,OR)和95%置信区间(confidence interval,CI),采用组内中位数赋值进行趋势检验;开展亚组分析并检验交互作用。构建两个模型:模型1未调整协变量;模型2调整性别、年龄、婚姻状况、教育水平、吸烟、饮酒、饮茶、喝饮料、糯米、油茶、高血压、糖尿病。使用限制性立方样条(restricted cubic spline,RCS)分析各指标与胆结石间的剂量反应关系,参数节点为4。检验水准α=0.05,双侧检验。
本研究共6 375名调查对象,胆结石检出率为10.9%(693/6 375),其中男性检出率为8.4%(192/2 274)、女性检出率为12.2%(501/4 101)。两组在年龄、性别、BMI、吸烟、饮酒、糯米、油茶、高血压、METS-VF、LAP、VAI和腰围间的差异具有统计学意义(P<0.05),与非胆结石者相比,胆结石患者METS-VF、LAP、VAI和腰围水平更高。见表1。
随着METS-VF、LAP、VAI和腰围四分位数的增加,胆结石检出率显著上升(P<0.001),如图1。未调整协变量时,内脏脂肪积累指标均与胆结石风险呈正相关(P for trend<0.001)。调整协变量后,各指标与胆结石风险仍正相关(P for trend<0.001),与Q1组相比,Q4组METS-VF、LAP、VAI、腰围的OR分别为2.206(95%CI:1.704~2.856)、2.280(95%CI:1.789~2.905)、1.674(95%CI:1.323~2.118)、2.046(95%CI:1.608~2.603)。见表2。
性别亚组分析显示,内脏脂肪积累指标与胆结石的关联存在性别异质性。在女性中,与Q1组相比,Q2~Q4组的METS-VF和LAP、Q4组的VAI、Q3~Q4组的腰围与胆结石患病风险正相关(P<0.05);在男性中,所有指标与胆结石关联均不显著(P>0.05);性别与METS-VF存在显著交互作用(P for interaction=0.007)。年龄亚组分析显示,在<60岁人群中,与Q1组相比,Q2~Q4组的METS-VF和LAP、Q3~Q4组的VAI和腰围患胆结石风险增加(P<0.05);在≥60岁人群中,Q3~Q4组的METS-VF、LAP及腰围与胆结石患病风险正相关(P<0.05)。不食用糯米人群中,各指标Q4组均与胆结石相关(P<0.05);食用糯米人群Q2~Q4组的METS-VF和LAP、Q3~Q4组的VAI和腰围患胆结石风险增加(P<0.05)。不喝油茶人群中,Q3~Q4组的METS-VF、Q4组的LAP和腰围与胆结石风险相关(P<0.05);喝油茶人群中除Q2组腰围外,均与胆结石患病风险正相关(P<0.05)。见图2。
RCS结果显示,各指标均与胆结石存在剂量反应关系(P for overall<0.001),其中METS-VF和腰围为线性关系(P for nonlinear=0.143、P for nonlinear=0.127),LAP和VAI为非线性关系(P for nonlinear<0.001)。见图3。
本研究发现,贵州省30~79岁侗族人群胆结石检出率为10.9%,女性检出率为12.2%,高于男性的8.4%。与其他国家、地区及民族存在差异,墨西哥胆结石患病率为25.8%[15],韩国为17.5%[16];国内数据显示,新疆胆结石患病率为10.3%[17],北京为3.7%[18];回族胆结石患病率为15.10%[19],彝族为4.6%[13]。这些差异可能源于遗传背景、饮食及生活方式等多种因素,胆结石具有遗传易感性,其患病率因种族而异,且居住在医疗资源有限或高脂、高胆固醇饮食的地区,可能增加胆结石风险,而久坐不动则会增加肥胖风险、降低胆囊活动能力,促进胆结石形成[20]。
肥胖会独立促进胆结石的形成,肥胖的核心特征是内脏脂肪堆积,为此本研究采用METS-VF、LAP、VAI和腰围共同评估内脏脂肪积累,并分析其与胆结石的关联。本研究表明,MEST-VF、LAP、VAI和腰围均与胆结石显著正相关,胆结石风险随指标升高而升高,内脏脂肪积累较高的女性比男性更易患胆结石。与Wu等的结果一致,其Q4组各指标OR值分别为3.338、2.481、1.885、3.154[21],与本研究效应值接近,这提示内脏脂肪积累对胆结石的致病效应在不同种族间可能具有跨人群的生物学一致性。Wang等[22]研究也表明METS-VF是胆结石的最强独立预测因子,且不同种族患病率不同。内脏脂肪积累可能通过以下机制增加胆结石风险,首先高MEST-VF、LAP、VAI通常伴有甘油三酯升高和HDL-C降低,甘油三酯升高会导致胆汁中胆固醇过饱和,促进胆固醇晶体形成和胆结石发生[23],而HDL-C与胆固醇逆向转运功能相关,HDL-C降低会减弱清除胆固醇的能力[24]。其次内脏脂肪积累会导致胰岛素抵抗,引发葡萄糖和脂质代谢改变,促进肝脏胆固醇合成,抑制胆汁酸分泌,导致胆汁中胆固醇饱和度升高[5]。内脏脂肪过多还会降低胆囊收缩与排空能力,致使胆汁淤积,胆囊内胆固醇沉积,增加胆结石形成可能性[25]。脂肪积累会引发内分泌功能失调,破坏正常胆固醇代谢并改变胆汁成分,增加胆结石形成易感性。
亚组分析显示,内脏脂肪积累指标与胆结石的关联存在性别差异,仅在女性中显著,且性别与METS-VF存在交互作用。这种性别特异性可能与女性雌激素升高影响胆固醇代谢和胆汁组成,导致胆固醇饱和度增加,以及黄体酮抑制胆囊排空,导致胆汁淤积等生理机制有关[26-27]。侗族女性生活方式也可能进一步放大内脏脂肪积累对胆结石的影响:侗族女性常饮用油茶,且是家庭事务的主要承担者,其休闲性体力活动或体育锻炼相对少于男性,这可能使能量消耗不足与高脂饮食叠加,导致内脏脂肪更易积累;侗族女性生育史、孕产期体重变化等也可能对脂质代谢产生影响。而尽管侗族男性内脏脂肪水平升高,但胆结石风险未同步增加,可能与男性饮酒率较高有关,长期大量饮酒会损伤肝细胞,影响胆汁酸合成[28],从而掩盖了内脏脂肪的独立效应;可能还存在其他未被测量的风险主导因素或保护性因素,如不同的酒精代谢模式等,未来需进一步深入研究。年龄亚组分析发现,METS-VF、LAP和腰围在不同年龄组中表现较稳定,较高分位数组均显著增加胆结石患病风险,而VAI与胆结石的关联在≥60岁人群中不显著,可能与该人群多有基础疾病、长期服药、控制饮食、降低胆固醇水平和改善胰岛素抵抗有关,间接减少胆结石患病风险,弱化了VAI与胆结石的关联。此外,老年人群代谢减缓,胆汁分泌减少,胆固醇浓度不高[29],以致内脏脂肪堆积对胆结石的促进作用被弱化,未来应在更大样本研究中进行验证。在食用糯米/油茶人群中,各指标与胆结石的关联更为广泛,表明长期食用糯米/油茶可能增强内脏脂肪指标对胆结石的影响,使较低水平的内脏脂肪积累即可增加患病风险。糯米具有高碳水、高血糖生成指数特性,油茶富含脂肪,长期大量食用可能导致餐后血糖波动较大,影响血脂代谢,促进脂肪合成与内脏脂肪堆积[30-31],从而放大了内脏脂肪积累对胆结石的致病效应。提示在该人群中,轻/中度的内脏脂肪升高也应予以重视,尽早开展体重管理与饮食干预,有助于降低胆结石患病风险。未来的研究可进一步探讨糯米、油茶等传统饮食与脂肪代谢、胆结石形成的具体机制,为制定针对性的公共卫生干预策略提供依据。
本研究结果提示,在贵州省侗族人群中,尤其是女性,可将内脏脂肪管理作为胆结石一级预防的核心策略。在实际风险筛查中,可根据应用场景、资源可及性等灵活选择指标:腰围测量简便、成本低,适用于大规模初筛;针对高危人群,采用结合血脂参数的LAP和VAI,能更敏感地反映与胆结石密切相关的内脏脂肪功能紊乱及其导致的代谢异常;而METS-VF整合了多维度代谢信息,能全面了解代谢健康状况,适用于临床精准评估,特别是对糖尿病前期、胰岛素抵抗等人群的胆结石风险预测。本研究亦存在局限性。首先,本研究为横断面研究无法确定因果关系,未来需开展前瞻性队列研究加以验证。其次,虽已调整多种混杂因素,但仍可能存在其他未考虑的混杂因素,且饮食数据依赖自我报告,可能存在回忆偏倚。体力活动作为重要混杂因素,但本研究数据未能精确量化体力活动强度,因此未纳入进行分析,可能对结果产生影响。最后,研究对象均为贵州省侗族常住居民,结论外推至其他民族或地区时需谨慎。
综上所述,METS-VF、LAP、VAI及腰围升高与贵州省侗族人群胆结石患病风险正相关,且存在女性特异性。其高脂高碳水的传统饮食可能进一步强化这种关联。未来应关注内脏脂肪积累的早期发现和管理,针对高危人群制定相应防治措施,以降低和预防因内脏脂肪积累导致的胆结石患病风险。本研究为在特定民族人群中开展基于内脏脂肪管理的胆结石精准防控策略,提供了重要的流行病学证据。
  • 国家重点研发计划课题(2017YFC0907301)
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doi: 10.20043/j.cnki.MPM.202512392
  • 接收时间:2025-12-24
  • 首发时间:2026-09-28
  • 出版时间:2026-07-10
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  • 收稿日期:2025-12-24
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国家重点研发计划课题(2017YFC0907301)
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    贵州医科大学公共卫生与健康学院,环境污染与疾病监控教育部重点实验室,贵州 贵阳 561113

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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
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