Relationship Between Alcohol Consumption And New-onset Gallstone Disease

Objective To explore the relationship between alcohol consumption and new-onset gallstone disease.Methods The retrospective cohort study was conducted.The data of 77 755 participants who participated health examination at the Kailuan General Hospital from June 2006 to December 2015 were collected.According to definition of alcohol consumption from literature,all the 77755 participants were allocated into the 5 groups,including 50695 with never drinking in the never group,3154 with alcohol withdrawal time?1 year in the past group,12410 with light drinking in the light group,1606 with moderate drinking in the moderate group and 9890 with heavy drinking in the heavy group.All participants received the same-order health examinations by the fixed team of doctors in 2006,2008,2010,2012 and 2014 at the same place.Epidemiological investigation,anthropometric parameters and biochemical indicators were collected.Measurement data with normal distribution were represented as x ±s,and comparisons among groups were analyzed using the one-way ANOVA.The pairwise comparison and homogeneity of variance were done using the least significance difference(LSD)test.Heterogeneity of variance was analyzed by the Dunnett?s T3 test.Measurement data with skewed distribution were described as M(Q),and comparisons among groups were analyzed using the rank sum test.Comparisons of count data were analyzed using chi-square test.The cumulative incidence of new-onset cholelithiasis was calculated by the Kaplan-Meier method,and comparisons of incidences among groups were done by the Log-rank test.The hazard ratio(HR)and 95% confidence interval(CI)of different intakes of alcohol on new-onset cholelithiasis were estimated by the COX proportional hazards regression models.The fitting degree of alcohol consumption on new-onset cholelithiasis model was calculated by the likelihood ratio test and akaike information criterion(AIC).Results(1)Comparisons of clinical characteristics among the 5 groups: male,age,systolic pressure,diastolic pressure,body mass index(BMI),total cholesterol(TC),triglyceride(TG),fasting plasma glucose(FPG)and waistline and cases with diabetes,hypertension,smoking and physical exercise were different in the heavy group,showing statistically significantdifferences among groups(P<0.05).(2)Incidence of cholelithiasis: all 77755 participants were observed for(6.8±2.1)years,3757 were diagnosed as new-onset cholelithiasis,with a cumulative incidence of new-onset cholelithiasis of 4.5%.The cumulative incidences of new onset cholelithiasis in the never,past,light,moderate and heavy groups were respectively 5.1%,4.9%,3.7%,3.4% and 3.3%,showing a statistically significant difference among groups(?2 = 83.14,P<0.05).The cumulative incidence of new-onset cholelithiasis in the never group was significantly different from that in the past,light,moderate and heavy groups(?2 = 18.34,40.58,45.41,48.44,P<0.05).The cumulative incidence of new onset cholelithiasis in the past group was significantly different from that in the light,moderate and heavy groups(?2 = 18.72,20.47,25.41,P< 0.05).There were statistically significant differences in the cumulative incidence of new-onset cholelithiasis among the light,moderate and heavy groups(?2 = 8.47,12.41,P < 0.05)and no statistically significant difference between the moderate and heavy groups(?2 = 0.85,P>0.05).(3)Risk factors analysis affecting new-onset cholelithiasis: results of COX proportional hazards regression models showed that risks of new-onset cholelithiasis in the light,moderate and heavy groups were reduced compared with never group after adjustment of gender,age,TC,TG,BMI,hypertension,diabetes,smoking and physical exercise(HR=0.88,0.82,0.73,95%CI: 0.79-0.98,0.76-0.89,0.64-0.83,P<0.05).(4)Comparisons of the fitting degree of alcohol consumption on new-onset cholelithiasis model: multivariate model was constructed after adding risk factors of gender,age,BMI,TG,TC,hypertension,diabetes mellitus,smoking and physical exercise,and-2Log L and AIC were 76331.83 and 76353.83 for the multivariate model.Then drinking variable was added into multivariate model,and the-2Log L and AIC of the multivariate model+drinking model were 76307.86 and 76337.86,respectively,with statistically significant differences(?2 = 23.97,P<0.05).Conclusion Alcohol consumption is an independent protective factor for new-onset GSD,and the risk of cholelithiasis is decreased with increasing alcohol intake.