Gallstone disease is associated with an increased risk of inflammatory bowel disease: results from three prospective cohort studies

Ningning Mi, Man Yang, Lina Wei, Peng Nie, Shukai Zham, Long H Nguyen, Fang Gao Smith, Animesh Acharjee, Xudong Lui, Junjie Huang, Bin Xia*, Yuan Jinqiu*, Wenbo Meng*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction:
Gallstone diseases impact intestinal inflammation, bile flow, and gut microbiota, which in turn may increase the risk of inflammatory bowel disease (IBD). However, epidemiological studies exploring the associations between gallstone diseases and subsequent IBD risk have been limited.

Methods:
This is a combined analysis of three prospective cohort studies (Nurses’ Health Study (NHS), NHS II, and UK Biobank), and replicated in a case-control study (Chinese IBD Etiology Study, CIES). We evaluated the hazard ratios (HRs) / odds ratios (ORs) between gallstone diseases with IBD risk by Cox- or conditional logistic-regression, adjusting for demographic characteristics, lifestyles, comorbidities, and medication usage.

Findings:
We identified 3480 cases of IBD over 2,127,471 person-years of follow-up in the 3 cohort studies. The participants with gallstone disease had a 38% increase in risk of IBD (HR 1.38, 95% confidence intervals [CI] 1.21-1.59), 68% increase in Crohn’s disease (CD) (HR 1.68, 95% CI 1.38-2.06) and 24% increase in ulcerative colitis (UC) (HR 1.24, 95% CI 1.03-1.49). In CIES, we found even larger magnitude of effects between gallstone diseases and IBD risk (IBD: OR 3.03, 95% CI 2.32-3.97; CD: OR 5.31; 95% CI 3.71-7.60; UC: OR 1.49; 95% CI 1.07-2.06). There were no major differences in the estimated associations between presence of unremoved gallstones and prior cholecystectomy with IBD risk.

Discussion:
Gallstone disease was linked to an increased risk of IBD and its subtypes, independent of traditional risk factors. Further research is needed to confirm these associations and clarify the underlying biological mechanisms
Original languageEnglish
Article number10.14309/ajg.0000000000003111
JournalThe American Journal of Gastroenterology
DOIs
Publication statusPublished - 4 Oct 2024

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