Ein gesunder Lebensstil und seine Assoziation zum Risiko von Gallensteinerkrankung
Zusammenfassung der Projektergebnisse
Symptomatic gallstone disease causes high financial and disease burden for public health systems. On average, 10-25% in Westernized countries are effected. Previous studies have shown that obesity, smoking, physical activity, and dietary factors play an important role in the development, but most studies focused on individual lifestyle factors. The combined effects of these lifestyle factors on the risk of symptomatic gallstone disease and the number of cases that could be prevented by a healthy lifestyle are unknown. We first investigated the association between three dietary patterns and the risk of symptomatic gallstone disease among men of the Health Professionals Follow-up Study. We used these results to include the best dietary pattern into a Healthy Lifestyle Score, which also included moderate alcohol consumption, physical activity, regular coffee consumption, not being overweight, and being non-smoker for at least 10 years. We then studied this Healthy Lifestyle Score with the risk of symptomatic gallstone disease in two large prospective cohort studies. In the Health Professionals Follow-up Study, higher adherence to dietary scores related to high quality diet [i.e., the alternate Mediterranean diet score (aMed), the Alternate Healthy Eating Index (AHEI-2010) and the Dietary Approaches to Stop Hypertension diet score (DASH)] was associated with an about 35% lower risk of symptomatic gallstone disease. Preliminary results from the Nurses’ Health Study showed the strongest inverse associations between the AHEI-2010 and the risk of cholecystectomy (gallbladder removal). As a consequence of these analyses, the AHEI-2010 was included into the final Healthy Lifestyle Score. Among 59,901 women from the Nurses’ Health Study and 39,849 men from the Health Professionals Follow-up Study, 8,088 women and 2,428 men reported symptomatic gallstone disease. Women with the lifestyle considered most healthy had a 71% lower risk of symptomatic gallstones than women with the lifestyle considered least healthy. For men this was even more pronounced (80%). If all participants would have adhered to the lowest risk lifestyle, about two-thirds of symptomatic gallstone cases might have been potentially preventable. Each healthy lifestyle factor contributed to the inverse effect of the Healthy Lifestyle Score. However, for women, no association was observed between smoking status and the risk of symptomatic gallstone disease. For both, men and women, being normal-weight was the strongest factor in the Healthy Lifestyle Score. 31% of female cases and 22% of male cases could have been prevented, if all participants would have been normal-weight. In conclusion, lifestyle modification, especially weight management reduces the enormous disease burden and financial load of symptomatic gallstone disease beyond the overall improvement in health and the risk reduction of major chronic diseases. Broader adoption of a healthy lifestyle may have a substantial impact on the health care systems. Our findings warrant further examination of the role of lifestyle modification on symptomatic gallstone disease in both intervention and observational studies, particularly those including more heterogeneous populations and high risk sub-populations (e.g. diabetics, obese).
Projektbezogene Publikationen (Auswahl)
- Presence of gallstones and the risk of cardiovascular diseases: The EPIC-Germany cohort study. Eur J Prev Cardiol. 2015 Mar;22(3):326-34
Wirth J, Giuseppe RD, Wientzek A, Katzke VA, Kloss M, Kaaks R, Boeing H, Weikert C
(Siehe online unter https://doi.org/10.1177/2047487313512218) - Dietary patterns and the risk of gallstone disease in the Health Professionals Follow-Up Study. HEC 2016, the congress of the GMDS & DGEpi & IEA-EEF annual meeting, Medical Informatics Europe 2016 in Munich (28.8.-2.9.2016)
Wirth J, Joshi Amit, Fung T, Chan A T, Weikert C, Leitzmann M, Giovannucci E and Wu K
- Gallstones and Risk of Coronary Heart Disease: Prospective Analysis of 270 000 Men and Women From 3 US Cohorts and Meta-Analysis. Arterioscler Thromb Vasc Biol. 2016;36(9):1997-2003
Zheng Y, Xu M, Li Y, Hruby A, Rimm E, Hu FB, Wirth J, Albert CM, Rexrode KM, Manson JE, Qui L
(Siehe online unter https://doi.org/10.1161/ATVBAHA.116.307507) - Diet-quality scores and the risk of symptomatic gallstone disease: a prospective cohort study of male US health professionals. Int J Epidemiol. 2018 Dec 1;47(6):1938-1946
Wirth J, Song M, Fung TT, Joshi AD, Tabung FK, Chan AT, Weikert C, Leitzmann M, Willett WC, Giovannucci E, Wu K
(Siehe online unter https://doi.org/10.1093/ije/dyy210)
