REGIONAL FAT DISTRIBUTION AS RISK FACTOR FOR CLINICALLY DIAGNOSED GALLSTONES IN MIDDLE-AGED MEN - A 25-YEAR FOLLOW-UP-STUDY (THE ZUTPHEN STUDY)

Obesity is considered to be an important risk factor for the formation of gallstones. The relationship is well established for women but not for men. In a long-term follow-up study of middle-aged men the relati onship between various markers of obesity and the incidence of clinica lly diagnosed gallstones during 25 years of follow-up was studied. Inf ormation on the presence of gallstones was obtained by self-report and verified through medical records after death. Of the 860 men who were between 40 and 59 years old at the start of the study, 54 developed g allstones, yielding an incidence rate of 3.1/1000 person-years. Cox pr oportional hazard models were used to examine the associations between the risk factors and newly diagnosed gallstones. Univariate analysis revealed that the subscapular-to-trieeps skinfold thickness ratio (STR ) yields a significant positive association (HR upper quartile: 2.5, 9 5% CI: 1.1-5.7). Subscapular skinfold thickness had a borderline signi ficant, positive association, which became significant after exclusion of subjects who developed symptomatic gallstones within the first 3 y ears of follow-up (HR upper quartile: 2.5, 95% CI: 1.0-6.2). The multi variate model revealed that the association of STR with clinically dia gnosed gallstones was independent of Body Mass Index. Our results indi cate that regional fat distribution, as measured by the subscapular-to -triceps skinfold thickness ratio, may play an important role in the f ormation of gallstones in men, as was previously found for women in ot her studies.