Relationship of serum leptin concentration and other measures of adipositywith gallbladder disease

Obesity increases the risk of gallstones, especially in women. Most gallbla dder disease studies have used body mass index (BMI) as a measure of overal l adiposity, although BMI does not distinguish between fat and lean body ma ss. Central adiposity may also increase gallstone risk, although this is le ss well studied. Leptin is a peptide whose serum concentration is highly co rrelated with total body fat mass. We examined the relationship of gallblad der disease with anthropometric measures and serum leptin concentration in a large, national, population-based study. A total of 13,962 adult particip ants in the Third National Health and Nutrition Examination Survey underwen t gallbladder ultrasonography and anthropometric measurements of BMI, body circumferences, and skinfold thicknesses, and a random subgroup of 5,568 ha d measures of fasting serum leptin concentrations. Gallstone-associated gal lbladder disease was defined as ultrasound-documented gallstones or evidenc e of cholecystectomy. When controlling for BMI and other gallbladder diseas e risk factors in multivariate analysis, a test for trend for increasing wa ist-to-hip circumference ratio and risk of gallbladder disease was statisti cally significant among women (P=.043) and men (P=.007). BMI remained stron gly associated with gallbladder disease among women (P < .001), but was unr elated among men (P=.46). Leptin concentration was associated with gallblad der disease in both sexes (P < .001), but not after controlling for BMI and waist-to-hip circumference in either women (P=.29) or men (P=.65). In conc lusion, waist-to-hip circumference ratio was related to gallbladder disease among women and men. Serum leptin concentration was not a better predictor of gallbladder disease than anthropometry.