To Explore The Association Between Gallbladder Cholesterol Stone And Cardiovascular Disease:a Cross-sectional Study

Background:Gallbladder cholesterol stone (GCS) have similar demographic, epidemiologic, dietary, metabolic, and genetic factors with Cardiovascular disease(CVD), and excess cholesterol with a similar cholesterol-bile metabolic signal pathway:farnesoid X receptor(FXR)/liver X receptor(LXR), is one main pathological characteristic shared between, which indicates that there may be potential relationship between these two diseases. Several studies have been performed to explore the association between GCS and CVD, but were spare and non-conclusive. We investigated the relationship between these two diseases at Tianjin Nankai Hospital in China by a cross-sectional study.Methods:The study population comprised22,150in-patients, aged more than18years, at Tianjin NanKai hospital in China from January2011to December2012. All subjects claimed data including age, gender, Hypertension, Diabetes Mellitus (DM), hyperlipidemia, CVD, Gallstone (GS) and metabolic factors, such as fasting plasma glucose (FPG), triglyceride (TG), total serum cholesterol (T-cho), high density lipoprotein cholesterol(HDL-C), and low density lipoprotein cholesterol(LDL-C), were searched. Multivariate logistic regression models were used to assess the adjusted association between GS and CVD.Results:1. There were8,032GS cases with an average age of59.0years (95%CI,58.6,59.3) compared to an average age of60.0years (95%CI,59.7,60.3) in14,118No-gallstone (NGS) group(P>0.05). Subjects with GS had a lower prevalence of CVD (29.5%) and low level of T-cho(4.47mmol/L)than controls (43.3%and4.52mmol/L)(P<0.0001).In multivariate logistic regress analysis, the risk for CVD for patients with GS was lower (OR,0.54;95%CI,0.50,0.58), and interaction of age (P=0.0009) as well as hypertension (P<0.0001) to the association between GS and CVD was significant, but no difference of gender (P=0.8774).2. There were8,484CVD cases with an average age of68.9years (95%CI,68.6,69.1) compared to an average age of53.9years (95%CI,53.6,54.1) in13,666 No-cardiovascualr disease (NCVD) group(P<0.0001). Subjects with CVD had a lower prevalence of GS (27.9%) than controls (41.4%)(P<0.0001), and in multivariate logistic regress analysis, the risk for GS for patients with CVD was lower (OR,0.51;95%CI,0.46,0.54).Conclusion:There is strong association between GCS and CVD, and the prevalence of CVD in GCS subjects, as well as GCS in CVD patients, was lower, which was most significant in aged-subjects (>70y) with hypertension while there was no difference between male and female. It may due to the function of hepatic pool of cholesterol that down-regulating level of total serum cholesterol in GCS patients.