Advanced inflammation a red flag for gallstone disease

Elevated high-sensitivity C-reactive protein levels (hs-CRP) appear to contribute to an increased risk of gallstone disease, as reported in a study.

Researchers followed a cohort of 95,319 individuals (mean age, 50.78 years; 78.83 percent male) residing in Tangshan City in northern China. Those with higher hs-CRP concentrations (1–3 and >3 mg/L vs <1 mg/L) were older, had larger waist circumference, and higher blood pressure, total cholesterol, fasting blood glucose, and white blood cell count.

Over a mean follow-up of 7.58 years, 4,205 developed gallstones, some of whom underwent cholecystectomy. The age- and sex-standardized overall incidence of gallstone disease was 6.99 per 1,000 person-years.

There was a positive association between hs-CRP and incident gallstone disease. The incidence rates were 5.96 per 1,000 person-years among individuals with hs-CRP <1 mg/L, 7.99 per 1,000 person-years among those with hs-CRP 1–3 mg/L, and 9.13 per 1,000 person-years among those with hs-CRP >3 mg/L.

Cox proportional hazards regression models showed that compared with the lowest tertile of hs-CRP concentration, the higher tertiles were associated with 11–12-percent increased risk of gallstone disease (1–3 mg/L: hazard ratio [HR], 1.11, 95 percent confidence interval [CI], 1.03–1.19; >3 mg/L: HR, 1.12, 95 percent CI, 1.04–1.22).

The inclusion of hs-CRP in the multivariate model (which consisted of age, sex, body mass index, total cholesterol, triglyceride, alanine aminotransferase, smoking status, drinking status, diabetes mellitus, hypertension, and physical activity) for identifying new cases of gallstone disease not only had a better line of fitness (according to the Akaike information criterion) but also had better accuracy.