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Screen-detected gallstone disease and cardiovascular disease

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Abstract

Knowledge about temporal associations for screen-detected gallstone disease and cardiovascular disease is limited. The objective of this study was to determine if screen-detected gallstones or cholecystectomy was associated with development of cardiovascular disease. A cohort study of three randomly selected groups from the general population of Copenhagen was performed. Participants (n = 5928) were examined 1982–1992 and underwent abdominal ultrasound examination to detect gallstone disease and were not informed of their gallstone status. Participants were followed up for occurrence of cardiovascular disease through nationwide registers until December 2014. Multivariable Cox regression analyses were performed including traditional cardiovascular disease risk factors and apolipoprotein E genotype. Gallstone disease was identified in 10% (591/5928) of participants at baseline of whom 6.8% had gallstones and 3.2% had cholecystectomy. The study population was followed for a period of 32 years with only 1% lost to follow-up. Gallstone disease was associated with all cardiovascular disease (hazard ratio (HR) 1.36, 95% confidence interval (CI) [1.17;1.59]) and to the subgroups coronary artery (HR 1.34, 95% CI [1.10;1.64]), cerebrovascular (HR 1.22, 95% CI [0.97;1.52]), and peripheral artery disease (HR 1.57, 95% CI [1.15;2.13]). No differences in estimates were identified for gallstones detected at ultrasound or cholecystectomy. Adjustment did not change estimates substantially. Gallstone disease seems to be independently associated to cardiovascular disease. Associations cannot be explained through traditional cardiovascular disease risk factors, apolipoprotein E4 allele, or detection bias. Future studies should explore the link between gallstone and cardiovascular disease further and gut microbiota may be a candidate mechanism.

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Acknowledgements

This study was supported financially by the Faculty of Health and Medical Sciences at the University of Copenhagen. We would like to thank Anja Lykke Madsen and Gert Mehl Virenfeldt for extracting data from the included databases and Rikke Kart Jacobsen for statistical supervision.

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Authors and Affiliations

  1. Digestive Disease Center, Bispebjerg University Hospital, Bispebjerg Bakke 23, Building 8, 2400, Copenhagen, Denmark

    Daniel Mønsted Shabanzadeh & Lars Tue Sørensen

  2. Research Centre for Prevention and Health, Capital Region of Denmark, Copenhagen, Denmark

    Daniel Mønsted Shabanzadeh, Tea Skaaby & Torben Jørgensen

  3. Institute for Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

    Lars Tue Sørensen

  4. Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

    Torben Jørgensen

  5. The Faculty of Medicine, Aalborg University, Aalborg, Denmark

    Torben Jørgensen

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  1. Daniel Mønsted Shabanzadeh
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Correspondence to Daniel Mønsted Shabanzadeh.

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Shabanzadeh, D.M., Skaaby, T., Sørensen, L.T. et al. Screen-detected gallstone disease and cardiovascular disease. Eur J Epidemiol 32, 501–510 (2017). https://doi.org/10.1007/s10654-017-0263-x

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