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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.

SUBMITTER: Zheng Y

PROVIDER: S-EPMC5001914 | biostudies-literature | 2016 Sep

REPOSITORIES: biostudies-literature

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Gallstones and Risk of Coronary Heart Disease: Prospective Analysis of 270 000 Men and Women From 3 US Cohorts and Meta-Analysis.

Zheng Yan Y Xu Min M Li Yanping Y Hruby Adela A Rimm Eric B EB Hu Frank B FB Wirth Janine J Albert Christine M CM Rexrode Kathryn M KM Manson JoAnn E JE Qi Lu L

Arteriosclerosis, thrombosis, and vascular biology 20160818 9

<h4>Objective</h4>Gallstone disease has been related to cardiovascular risk factors; however, whether presence of gallstones predicts coronary heart disease (CHD) is not well established.<h4>Approach and results</h4>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; 198 ...[more]

PMID: 27540264

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Project description:Importance:Glucosinolates, a group of phytochemicals abundant in cruciferous vegetables, may have cardioprotective properties. However, no prospective study has evaluated the association of intake of glucosinolates with the risk of coronary heart disease (CHD). Objective:The objective of the study was to evaluate the association between the intake of glucosinolates and incident CHD in US men and women. Design:Prospective longitudinal cohort study. Setting:Health professionals in the USA. Participants:We followed 74,241 women in the Nurses' Health Study (NHS; 1984-2012), 94,163 women in the NHSII (1991-2013), and 42,170 men in the Health Professionals Follow-Up Study (1986-2012), who were free of cardiovascular disease and cancer at baseline. Exposure:Glucosinolate intake was assessed using validated semi-quantitative food frequency questionnaires at baseline and updated every 2-4 years during follow-up. Main outcome measures:Incident cases of CHD were confirmed by medical record review. Results:During 4,824,001 person-years of follow-up, 8,010 cases of CHD were identified in the three cohorts. After adjustment for major lifestyle and dietary risk factors of CHD, weak but significantly positive associations were observed for glucosinolates with CHD risk when comparing the top with bottom quintiles (hazard ratio [HR]:1.09; 95% CI: 1.01, 1.17; Ptrend<0.001). Higher intakes of three major subtypes of glucosinolates were consistently associated with a higher CHD risk, although the association for indolylglucosinolate did not achieve statistical significance. Regarding cruciferous vegetable intake, participants who consumed one or more servings per week of Brussels sprouts (HR: 1.16; 95% CI: 1.06, 1.26; P<0.001) and cabbage (HR: 1.09; 95% CI: 1.02, 1.17; P=0.009) had a significantly higher CHD risk than those who consumed these cruciferous vegetables less than once per month. Conclusion and relevance:In these three prospective cohort studies, dietary glucosinolate intake was associated with a slightly higher risk of CHD in US adults. These results warrant replications in further studies including biomarker-based studies. Further studies are needed to confirm these findings and elucidate mechanistic pathways that may underlie these associations.

Project description:Study questionWhat is the prevalence of infertility and of help seeking among women and men in Britain?Summary answerOne in eight women and one in ten men aged 16-74 years had experienced infertility, defined by unsuccessfully attempting pregnancy for a year or longer, and little more than half of these people sought medical or professional help.What is known alreadyEstimates of infertility and help seeking in Britain vary widely and are not easily comparable because of different definitions and study populations.Study design, size, durationA cross-sectional population survey was conducted between 2010 and 2012 with a sample of 15 162 women and men aged 16-74 years.Participants/materials, setting, methodsParticipants completed the Natsal-3 questionnaire, using computer-assisted personal interviewing (CAPI) and computer-assisted self-interview (CASI).Main results and the role of chanceThe reported prevalence of infertility was 12.5% (CI 95% 11.7-13.3) among women and 10.1% (CI 95% 9.2-11.1) among men. Increased prevalence was associated with later cohabitation with a partner, higher socio-economic status and, for those who had a child, becoming parents at older ages. The reported prevalence of help seeking was 57.3% (CI 95% 53.6-61.0) among women and 53.2% (CI 95% 48.1-58.1) among men. Help seekers were more likely to be better educated and in higher status occupations and, among those who had a child, to have become parents later in life.Limitations, reasons for cautionThese data are cross-sectional so it is not possible to establish temporality or infer causality. Self-reported data may be subject to recall bias.Wider implications of the findingsThe study provides estimates of infertility and help seeking in Britain and the results indicate that the prevalence of infertility is higher among those delaying parenthood. Those with higher educational qualifications and occupational status are more likely to consult with medical professionals for fertility problems than others and these inequalities in help seeking should be considered by clinical practice and public health.Study funding/competing interestsFunding was provided by grants from the Medical Research Council and the Wellcome Trust, with support from the Economic and Social Research Council and the Department of Health. AMJ is a Governor of the Wellcome Trust. Other authors have no competing interests.

Dataset Information

Gallstones and Risk of Coronary Heart Disease: Prospective Analysis of 270?000 Men and Women From 3 US Cohorts and Meta-Analysis.

Publications

Gallstones and Risk of Coronary Heart Disease: Prospective Analysis of 270 000 Men and Women From 3 US Cohorts and Meta-Analysis.

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