Associations between novel anthropometric indices and the prevalence of gallstones among 6,848 adults: a cross-sectional study

Abstract

Background: Traditional anthropometric measures, including body mass index (BMI), are insufficient for evaluating gallstone risk. This study investigated the association between novel anthropometric indices and gallstone risk among 6,848 participants from the National Health and Nutrition Examination Survey in the United States.

Methods: Measures calculated included weight (WT), BMI, waist circumference (WC), waist-to-height ratio (WtHR), conicity index (CI), A Body Shape Index (ABSI), Body Roundness Index (BRI), Abdominal Volume Index (AVI), and Weight-adjusted Waist Index (WWI). Logistic regression and smooth curve fitting assessed the relationships between these indices and gallstones, complemented by receiver operating characteristic (ROC) curve analysis to evaluate their discriminative power.

Results: The results indicated significant differences between study groups, with a positive and independent correlation identified between gallstones and all measures except ABSI. Specifically, per 1 SD increase in WC, WT, BMI, WtHR, and AVI was associated with a 57%, 59%, 52%, 53%, and 53% increased risk of gallstones, respectively. Dose-response analysis confirmed a positive correlation between these indices and gallstone risk. ROC analysis highlighted WtHR and BRI as having superior discriminative abilities (AUC = 0.6703). Further, among participants with a BMI < 30 kg/m2, elevated levels of WT, WtHR, CI, BRI, and WWI significantly increased the risk of gallstones (P < 0.001). Likewise, elevated BMI heightened the risk at low levels of WT, WC, WtHR, BRI, AVI, and CI (P < 0.001).

Conclusion: This study supports the positive association between various anthropometric indicators and gallstones, recommending that newer anthropometric indices be considered more extensively to enhance gallstone prevention and treatment strategies.

Keywords: NHANES (National Health and Nutrition Examination Survey); abdominal obesity; cross-sectional study; gallstones; novel anthropometric indices.

FIGURE 1

Dose–response relationship analysis between anthropometric measures and gallstones. The area between the upper and lower dashed lines is represented as the 95% CI. Each point shows the magnitude of the anthropometric measures and is connected to form a continuous line. GAM regression was adjusted for gender, age, race/ethnicity, marital status, physical activity, alcohol, smoking, total water intake, total carbohydrate intake, total fat intake, total protein intake, hypertension, diabetes, cancer, CVD. (A) association between WT and the risk of gallstones; (B) association between BMI and the risk of gallstones; (C) association between WC and the risk of gallstones; (D) association between WtHR and the risk of gallstones; (E) association between BRI and the risk of gallstones; (F) association between AVI and the risk of gallstones; (G) association between WWI and the risk of gallstones; (H) association between CI and the risk of gallstones. BMI, body mass index; CI, conicity index; WC, waist circumference; WT, weight; WtHR, waist-to-height ratio; BRI, body roundness index; AVI, abdominal volume index; WWI, weight-adjusted waist index.

FIGURE 2

ROC curves of anthropometric measures for discriminating gallstone. ROC, receiver operating characteristic; AUC, area under the curve; BMI, body mass index; CI, conicity index; WC, waist circumference; WT, weight; WtHR, waist-to-height ratio; BRI, body roundness index; AVI, abdominal volume index; WWI, weight-adjusted waist index.

FIGURE 3

Association between gallstones and combined anthropometric indices. Multivariable logistic regression was conducted after adjusting for confounding factors of gender, age, race/ethnicity, marital status, physical activity, alcohol, smoking, total water intake, total carbohydrate intake, total fat intake, total protein intake, hypertension, diabetes, cancer, CVD.