BODY-MASS INDEX, CIGARETTE-SMOKING, AND OTHER CHARACTERISTICS AS PREDICTORS OF SELF-REPORTED, PHYSICIAN-DIAGNOSED GALLBLADDER-DISEASE IN MALE COLLEGE ALUMNI

Despite the high prevalence of gallbladder disease in industrialized c ountries, little is known about the predictors of the disease, especia lly in men. The authors prospectively studied 16,785 alumni of Harvard University, aged 15-24 years, who were followed for up to 61 years. T he health characteristics of these men were ascertained from their col lege entrance physical examination done in 1916-1950, and updated via mailed questionnaires in 1962 or 1966 (1962/1966). Alumni subsequently self-reported physician-diagnosed gallbladder disease on further mail ed questionnaires in 1972 or 1977. Between college time and 1962/1966, 371 gallbladder disease cases occurred. An additional 314 cases occur red after 1962/1966. With respect to college characteristics, after ad justment for potential confounders, the authors found that body mass i ndex (BMI), smoking, physical activity, blood pressure, and consumptio n of alcohol, coffee, or tea were unrelated to risk. However, BMI in 1 962/1966 was directly related to risk of subsequent gallbladder diseas e, as was BMI gain since college (p, trend = 0.002 and 0.013, respecti vely). Compared with men with BMI <22.0, men with BMI greater than or equal to 27.0 had a rate ratio of 2.71 (95% confidence interval (CI) 1 .57-4.66) for risk of contracting the disease. Men who gained greater than or equal to 6.0 BMI units since college had a rate ratio of 1.46 (95% CI 0.86-2.46) compared with men who gained -0.9 to +0.9 BMI units . Compared with never smokers, men who smoked pipes or cigars or <1 pa ck of cigarettes daily in 1962/1966 had a rate ratio of 1.43 (95% CI 1 .00-2.06), while heavier cigarette smokers had a rate ratio of 1.52 (9 5% CI 1.03-2.24). Neither physical activity nor physician-diagnosed hy pertension or diabetes mellitus in 1962/1966 predicted risk.