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Cynthia A Thomson - One of the best experts on this subject based on the ideXlab platform.
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vegetable protein intake is associated with lower Gallbladder Disease risk findings from the women s health initiative prospective cohort
Preventive Medicine, 2016Co-Authors: Eric M Lander, Betsy C Wertheim, Stephanie M Koch, Zhao Chen, Chiuhsieh Hsu, Cynthia A ThomsonAbstract:Objective This study aimed to measure associations between Gallbladder Disease and protein intake patterns, separated by quantity and type (vegetable vs. animal), among postmenopausal women. Methods Analyses were based on 130,859 postmenopausal women enrolled from 1993 to 1998 at 40 U.S. clinical centers in the Women's Health Initiative clinical trials and observational study. Women were excluded if they reported a history of Gallbladder Disease prior to baseline. Cox proportional hazards regression models, adjusted for Gallbladder Disease risk factors, were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between energy-adjusted protein intake and Gallbladder Disease. Results In this study sample, 8.1% of postmenopausal women self-reported incident Gallbladder Disease. In multivariate analysis, women in the highest quintile of energy-adjusted vegetable protein intake (> 24.0 g/d) had a lower risk of Gallbladder Disease (HR, 0.87; 95% CI, 0.81–0.93) as compared to women in the lowest quintile (< 16.3 g/d) (Ptrend < 0.001). Total protein intake was modestly protective against Gallbladder Disease (Ptrend < 0.021). Animal protein intake was not associated with Gallbladder Disease risk. The protective effect of vegetable protein held stable only for women without history of diabetes (HR, 0.86; 95% CI, 0.80–0.92) and without recent weight loss (HR, 0.88; 95% CI, 0.80–0.97). Conclusions Vegetable protein intake is inversely associated with Gallbladder Disease risk in our sample of postmenopausal women. In addition to weight management, healthcare providers could emphasize vegetable protein as an additional dietary modality to promote lower risk for Gallbladder Disease.
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vegetable protein intake is associated with lower Gallbladder Disease risk findings from the women s health initiative prospective cohort
Preventive Medicine, 2016Co-Authors: Eric M Lander, Betsy C Wertheim, Stephanie M Koch, Zhao Chen, Chiuhsieh Hsu, Cynthia A ThomsonAbstract:Abstract Objective This study aimed to measure associations between Gallbladder Disease and protein intake patterns, separated by quantity and type (vegetable vs. animal), among postmenopausal women. Methods Analyses were based on 130,859 postmenopausal women enrolled from 1993 to 1998 at 40 U.S. clinical centers in the Women's Health Initiative clinical trials and observational study. Women were excluded if they reported a history of Gallbladder Disease prior to baseline. Cox proportional hazards regression models, adjusted for Gallbladder Disease risk factors, were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between energy-adjusted protein intake and Gallbladder Disease. Results In this study sample, 8.1% of postmenopausal women self-reported incident Gallbladder Disease. In multivariate analysis, women in the highest quintile of energy-adjusted vegetable protein intake (> 24.0 g/d) had a lower risk of Gallbladder Disease (HR, 0.87; 95% CI, 0.81–0.93) as compared to women in the lowest quintile ( Conclusions Vegetable protein intake is inversely associated with Gallbladder Disease risk in our sample of postmenopausal women. In addition to weight management, healthcare providers could emphasize vegetable protein as an additional dietary modality to promote lower risk for Gallbladder Disease.
Dagfinn Aune - One of the best experts on this subject based on the ideXlab platform.
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physical activity and the risk of Gallbladder Disease a systematic review and meta analysis of cohort studies
Journal of Physical Activity and Health, 2016Co-Authors: Dagfinn Aune, Michael F Leitzmann, Lars J. VattenAbstract:Background: Physical activity has been hypothesized to reduce the risk of Gallbladder Disease (gallstones, cholecystitis, cholecystectomy); however, results from epidemiological studies have not always shown statistically significant associations. We conducted a systematic review and meta-analysis to clarify the presence and strength of an association between physical activity and Gallbladder Disease risk. Methods: PubMed and Embase databases were searched for studies of physical activity and Gallbladder Disease up to 9th of January 2015. Prospective studies reporting relative risk (RR) estimates and 95% confidence intervals (CIs) of Gallbladder Disease associated with physical activity were included. Summary RRs were estimated using a random effects model. Results: Eight studies including 6958 cases and 218,204 participants were included. The summary RR for the highest versus the lowest level of physical activity was 0.75 (95% CI: 0.69–0.81, n = 8) and there was no evidence of heterogeneity, I2 = 0%). In...
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Tobacco smoking and the risk of Gallbladder Disease
European Journal of Epidemiology, 2016Co-Authors: Dagfinn Aune, Lars J. Vatten, Paolo BoffettaAbstract:Tobacco smoking has been inconsistently associated with Gallbladder Disease risk. To clarify the association we conducted a systematic review and meta-analysis of cohort studies published on the subject. We searched the PubMed and Embase databases for studies of smoking and Gallbladder Disease up to January 9th 2015. Prospective studies were included if they reported relative risk estimates and 95 % confidence intervals of Gallbladder Disease associated with current, former or ever smoking and by number of cigarettes per day. Summary relative risks were estimated by use of a random effects model. We identified ten prospective studies including 59,530 Gallbladder Disease cases among 4,213,482 participants that could be included in the meta-analysis. The summary RR was 1.19 (95 % CI 1.12–1.28, I^2 = 46.9 %, n = 6) for current smokers, 1.10 (95 % CI 1.07–1.13, I^2 = 0 %, n = 6) for former smokers and 1.15 (95 % CI 1.13–1.18, I^2 = 0 %, n = 7) for ever smokers. In the dose–response analysis the summary relative risk was 1.11 (95 % CI 1.08–1.14, I^2 = 33 %, n = 3) per 10 cigarettes per day and although there was indication of nonlinearity there was a dose-dependent positive association with increasing number of cigarettes smoked per day. The current meta-analysis provides evidence of an increased risk of Gallbladder Disease associated with tobacco smoking.
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diabetes mellitus and the risk of Gallbladder Disease a systematic review and meta analysis of prospective studies
Journal of Diabetes and Its Complications, 2016Co-Authors: Dagfinn Aune, Lars J. VattenAbstract:Abstract Background Diabetes has been hypothesized to increase the risk of Gallbladder Disease based on the observation that obesity and insulin resistance are associated with Gallbladder Disease. Although several studies have investigated the association between a diabetes diagnosis and risk of Gallbladder Disease, the results have not been entirely consistent. For this reason we conducted a systematic review and meta-analysis of the available cohort studies. Materials and methods We searched the PubMed and Embase databases for studies of diabetes and Gallbladder Disease (defined as gallstones, cholecystectomy, or cholecystitis) up to January 9th 2015. Prospective studies were included if they reported relative risk estimates and 95% confidence intervals of Gallbladder Disease associated with a diabetes diagnosis. Summary relative risks were estimated by use of a random effects model. Results We identified 10 prospective studies that could be included in the meta-analysis which included 223,651 cases among 7,365,198 participants. The summary RR for diabetes patients was 1.56 (95% CI: 1.26–1.93, I 2 =99.4%, p heterogeneity Conclusions Our analysis provides further support for an increased risk of Gallbladder Disease among diabetes patients.
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body mass index abdominal fatness and the risk of Gallbladder Disease
European Journal of Epidemiology, 2015Co-Authors: Dagfinn Aune, Teresa Norat, Lars J. VattenAbstract:Epidemiological studies have indicated a positive association between adiposity and Gallbladder Disease risk, however, the shape of the dose–response relationship and differences between overall and abdominal adiposity remains to be clarified. We conducted a systematic review and dose–response meta-analysis of cohort studies of body mass index (BMI), waist circumference and waist-to-hip ratio and risk of Gallbladder Disease. PubMed and Embase databases were searched up to January 9th 2015. Summary relative risks were calculated using a random effects model. Seventeen prospective studies of BMI and Gallbladder Disease risk with 55,670 cases among 1,921,103 participants were included. The summary relative risk (RR) for a 5 unit increment in BMI was 1.63 (95 % CI 1.49–1.78, I2 = 98 %). There was evidence of a nonlinear association overall and among women, pnonlinearity < 0.0001, but not among men, pnonlinearity = 0.99, with a slight flattening of the curve at very high BMI levels (BMI 40–45), however, the risk of Gallbladder Disease increased almost twofold even within the “normal” BMI range. The summary RR for a 10 cm increase in waist circumference was 1.46 (95 % CI 1.24–1.72, I2 = 98 %, n = 5) and for a 0.1 unit increment in waist-to-hip ratio was 1.44 (95 % CI 1.26–1.64, I2 = 92 %, n = 4). Associations were attenuated, but still significant, when BMI and abdominal adiposity measures were mutually adjusted. Our results confirm a positive association between both general and abdominal fatness and the risk of Gallbladder Disease. There is an almost twofold increase in the risk even within the “normal” BMI range, suggesting that even moderate increases in BMI may increase risk.
Lars J. Vatten - One of the best experts on this subject based on the ideXlab platform.
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physical activity and the risk of Gallbladder Disease a systematic review and meta analysis of cohort studies
Journal of Physical Activity and Health, 2016Co-Authors: Dagfinn Aune, Michael F Leitzmann, Lars J. VattenAbstract:Background: Physical activity has been hypothesized to reduce the risk of Gallbladder Disease (gallstones, cholecystitis, cholecystectomy); however, results from epidemiological studies have not always shown statistically significant associations. We conducted a systematic review and meta-analysis to clarify the presence and strength of an association between physical activity and Gallbladder Disease risk. Methods: PubMed and Embase databases were searched for studies of physical activity and Gallbladder Disease up to 9th of January 2015. Prospective studies reporting relative risk (RR) estimates and 95% confidence intervals (CIs) of Gallbladder Disease associated with physical activity were included. Summary RRs were estimated using a random effects model. Results: Eight studies including 6958 cases and 218,204 participants were included. The summary RR for the highest versus the lowest level of physical activity was 0.75 (95% CI: 0.69–0.81, n = 8) and there was no evidence of heterogeneity, I2 = 0%). In...
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Tobacco smoking and the risk of Gallbladder Disease
European Journal of Epidemiology, 2016Co-Authors: Dagfinn Aune, Lars J. Vatten, Paolo BoffettaAbstract:Tobacco smoking has been inconsistently associated with Gallbladder Disease risk. To clarify the association we conducted a systematic review and meta-analysis of cohort studies published on the subject. We searched the PubMed and Embase databases for studies of smoking and Gallbladder Disease up to January 9th 2015. Prospective studies were included if they reported relative risk estimates and 95 % confidence intervals of Gallbladder Disease associated with current, former or ever smoking and by number of cigarettes per day. Summary relative risks were estimated by use of a random effects model. We identified ten prospective studies including 59,530 Gallbladder Disease cases among 4,213,482 participants that could be included in the meta-analysis. The summary RR was 1.19 (95 % CI 1.12–1.28, I^2 = 46.9 %, n = 6) for current smokers, 1.10 (95 % CI 1.07–1.13, I^2 = 0 %, n = 6) for former smokers and 1.15 (95 % CI 1.13–1.18, I^2 = 0 %, n = 7) for ever smokers. In the dose–response analysis the summary relative risk was 1.11 (95 % CI 1.08–1.14, I^2 = 33 %, n = 3) per 10 cigarettes per day and although there was indication of nonlinearity there was a dose-dependent positive association with increasing number of cigarettes smoked per day. The current meta-analysis provides evidence of an increased risk of Gallbladder Disease associated with tobacco smoking.
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diabetes mellitus and the risk of Gallbladder Disease a systematic review and meta analysis of prospective studies
Journal of Diabetes and Its Complications, 2016Co-Authors: Dagfinn Aune, Lars J. VattenAbstract:Abstract Background Diabetes has been hypothesized to increase the risk of Gallbladder Disease based on the observation that obesity and insulin resistance are associated with Gallbladder Disease. Although several studies have investigated the association between a diabetes diagnosis and risk of Gallbladder Disease, the results have not been entirely consistent. For this reason we conducted a systematic review and meta-analysis of the available cohort studies. Materials and methods We searched the PubMed and Embase databases for studies of diabetes and Gallbladder Disease (defined as gallstones, cholecystectomy, or cholecystitis) up to January 9th 2015. Prospective studies were included if they reported relative risk estimates and 95% confidence intervals of Gallbladder Disease associated with a diabetes diagnosis. Summary relative risks were estimated by use of a random effects model. Results We identified 10 prospective studies that could be included in the meta-analysis which included 223,651 cases among 7,365,198 participants. The summary RR for diabetes patients was 1.56 (95% CI: 1.26–1.93, I 2 =99.4%, p heterogeneity Conclusions Our analysis provides further support for an increased risk of Gallbladder Disease among diabetes patients.
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body mass index abdominal fatness and the risk of Gallbladder Disease
European Journal of Epidemiology, 2015Co-Authors: Dagfinn Aune, Teresa Norat, Lars J. VattenAbstract:Epidemiological studies have indicated a positive association between adiposity and Gallbladder Disease risk, however, the shape of the dose–response relationship and differences between overall and abdominal adiposity remains to be clarified. We conducted a systematic review and dose–response meta-analysis of cohort studies of body mass index (BMI), waist circumference and waist-to-hip ratio and risk of Gallbladder Disease. PubMed and Embase databases were searched up to January 9th 2015. Summary relative risks were calculated using a random effects model. Seventeen prospective studies of BMI and Gallbladder Disease risk with 55,670 cases among 1,921,103 participants were included. The summary relative risk (RR) for a 5 unit increment in BMI was 1.63 (95 % CI 1.49–1.78, I2 = 98 %). There was evidence of a nonlinear association overall and among women, pnonlinearity < 0.0001, but not among men, pnonlinearity = 0.99, with a slight flattening of the curve at very high BMI levels (BMI 40–45), however, the risk of Gallbladder Disease increased almost twofold even within the “normal” BMI range. The summary RR for a 10 cm increase in waist circumference was 1.46 (95 % CI 1.24–1.72, I2 = 98 %, n = 5) and for a 0.1 unit increment in waist-to-hip ratio was 1.44 (95 % CI 1.26–1.64, I2 = 92 %, n = 4). Associations were attenuated, but still significant, when BMI and abdominal adiposity measures were mutually adjusted. Our results confirm a positive association between both general and abdominal fatness and the risk of Gallbladder Disease. There is an almost twofold increase in the risk even within the “normal” BMI range, suggesting that even moderate increases in BMI may increase risk.
Eric M Lander - One of the best experts on this subject based on the ideXlab platform.
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vegetable protein intake is associated with lower Gallbladder Disease risk findings from the women s health initiative prospective cohort
Preventive Medicine, 2016Co-Authors: Eric M Lander, Betsy C Wertheim, Stephanie M Koch, Zhao Chen, Chiuhsieh Hsu, Cynthia A ThomsonAbstract:Objective This study aimed to measure associations between Gallbladder Disease and protein intake patterns, separated by quantity and type (vegetable vs. animal), among postmenopausal women. Methods Analyses were based on 130,859 postmenopausal women enrolled from 1993 to 1998 at 40 U.S. clinical centers in the Women's Health Initiative clinical trials and observational study. Women were excluded if they reported a history of Gallbladder Disease prior to baseline. Cox proportional hazards regression models, adjusted for Gallbladder Disease risk factors, were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between energy-adjusted protein intake and Gallbladder Disease. Results In this study sample, 8.1% of postmenopausal women self-reported incident Gallbladder Disease. In multivariate analysis, women in the highest quintile of energy-adjusted vegetable protein intake (> 24.0 g/d) had a lower risk of Gallbladder Disease (HR, 0.87; 95% CI, 0.81–0.93) as compared to women in the lowest quintile (< 16.3 g/d) (Ptrend < 0.001). Total protein intake was modestly protective against Gallbladder Disease (Ptrend < 0.021). Animal protein intake was not associated with Gallbladder Disease risk. The protective effect of vegetable protein held stable only for women without history of diabetes (HR, 0.86; 95% CI, 0.80–0.92) and without recent weight loss (HR, 0.88; 95% CI, 0.80–0.97). Conclusions Vegetable protein intake is inversely associated with Gallbladder Disease risk in our sample of postmenopausal women. In addition to weight management, healthcare providers could emphasize vegetable protein as an additional dietary modality to promote lower risk for Gallbladder Disease.
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vegetable protein intake is associated with lower Gallbladder Disease risk findings from the women s health initiative prospective cohort
Preventive Medicine, 2016Co-Authors: Eric M Lander, Betsy C Wertheim, Stephanie M Koch, Zhao Chen, Chiuhsieh Hsu, Cynthia A ThomsonAbstract:Abstract Objective This study aimed to measure associations between Gallbladder Disease and protein intake patterns, separated by quantity and type (vegetable vs. animal), among postmenopausal women. Methods Analyses were based on 130,859 postmenopausal women enrolled from 1993 to 1998 at 40 U.S. clinical centers in the Women's Health Initiative clinical trials and observational study. Women were excluded if they reported a history of Gallbladder Disease prior to baseline. Cox proportional hazards regression models, adjusted for Gallbladder Disease risk factors, were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between energy-adjusted protein intake and Gallbladder Disease. Results In this study sample, 8.1% of postmenopausal women self-reported incident Gallbladder Disease. In multivariate analysis, women in the highest quintile of energy-adjusted vegetable protein intake (> 24.0 g/d) had a lower risk of Gallbladder Disease (HR, 0.87; 95% CI, 0.81–0.93) as compared to women in the lowest quintile ( Conclusions Vegetable protein intake is inversely associated with Gallbladder Disease risk in our sample of postmenopausal women. In addition to weight management, healthcare providers could emphasize vegetable protein as an additional dietary modality to promote lower risk for Gallbladder Disease.
Roshan Shrestha - One of the best experts on this subject based on the ideXlab platform.
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Endoscopic stent insertion into the Gallbladder for symptomatic Gallbladder Disease in patients with end-stage liver Disease.
Gastrointestinal Endoscopy, 2005Co-Authors: Jason Conway, Mark W. Russo, Roshan ShresthaAbstract:Background Endoscopic stent insertion into the Gallbladder entails placement of a double-pigtail polyethylene stent between the Gallbladder and the duodenum at ERCP. This procedure may be an effective temporary measure in patients with severe comorbid conditions, especially end-stage liver Disease, that subsequently allows more definitive therapy, including liver transplantation. Methods The records for 29 patients who underwent attempted endoscopic Gallbladder stent insertion between May 1999 and May 2004 were reviewed retrospectively. Results Mean patient age was 47 years; 86% of the patients were listed for liver transplantation, with a mean model for end-stage liver Disease score of 15; 72% had Child's class B cirrhosis. Indications for Gallbladder stent placement included recurrent biliary colic (69%), acute cholecystitis (17%), acalculous cholecystitis (7%), and gallstone pancreatitis (7%). Of the 29 patients who underwent ERCP, stent placement was successful in 26 (90%). Median follow-up was 9.4 months (range 0.1-40.5 months). Of those who had a stent placed, 6 (22%) subsequently underwent liver transplantation and another 15 (56%) were alive, most awaiting liver transplantation. Only 3 patients had late a complication or recurrence of biliary symptoms after stent placement. Conclusions Endoscopic stent placement in the Gallbladder is a safe and an effective palliative treatment for patients with symptoms caused by Gallbladder Disease who are poor surgical candidates.
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endoscopic stenting of the Gallbladder for symptomatic Gallbladder Disease in patients with end stage liver Disease awaiting orthotopic liver transplantation
Liver Transplantation, 1999Co-Authors: Roshan Shrestha, Thomas E. Trouillot, Gregory T. EversonAbstract:Cholecystectomy in patients with advanced cirrhosis is associated with excessive morbidity and mortality. Because open cholecystectomy in patients with Child's class C cirrhosis has a reported mortality rate as high as 83%, symptomatic Gallbladder Disease in patients awaiting orthotopic liver transplantation (OLT) poses a unique clinical problem. The goal of this study is to determine whether the treatment of symptomatic Gallbladder Disease with endoscopic stenting of the Gallbladder effectively reduces biliary symptoms and complications or the need for cholecystectomy. Thirteen patients with symptomatic Gallbladder Disease with and without cholelithiasis and advanced cirrhosis who were candidates for OLT underwent placement of a biliary stent from the Gallbladder to the duodenum at endoscopic retrograde cholangiography. In each patient, biliary symptoms and complications ceased after stent placement. Seven patients underwent successful OLT 1 to 24 months after the procedure. One patient subsequently became a noncandidate for OLT and died of diabetes complications 3 years after the procedure. Five others are awaiting OLT (6 to 28 months postprocedure). One patient had recurrent pericholecystic fluid collection requiring percutaneous drainage and antibiotic therapy 8 months after the procedure. No patient has had recurrent symptoms, and currently all patients are free of complications. None required surgical intervention of the Gallbladder or biliary tree. We conclude that endoscopic stenting of the Gallbladder is the preferred treatment for symptomatic Gallbladder Disease in patients with end-stage liver Disease awaiting OLT. This approach is noninvasive, safe, and effective in preventing potential morbidity and mortality.
