{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T09:05:08Z","timestamp":1784019908085,"version":"3.55.0"},"reference-count":36,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Int Med Res"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine the association between dietary flavonoid intake and gallstone prevalence in a representative United States sample using National Health and Nutrition Examination Survey 2017\u20132018 data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross-sectional study included 4087 adults aged \u226520 years. Flavonoid intake was assessed using the United States Department of Agriculture Food and Nutrient Database for Dietary Studies and covered 29 flavonoids across six subclasses. Gallstones were defined by self-reported physician diagnosis. Covariates included demographics, lifestyle, and health status. Multivariate logistic regression, weighted quantile sum, quantile g-computation, and Bayesian kernel machine regression models were used to evaluate the individual and combined effects of flavonoids.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Gallstone prevalence was 11.00% (n\u2009=\u2009475). A U-shaped relationship was observed for total flavonoid intake, with lower intakes negatively and higher intakes positively associated with gallstone prevalence. Among females, higher total flavonoid and flavonol intakes were significantly associated with increased gallstone prevalence. Specific flavonoids, including theaflavins and thearubigins, were associated with gallstone prevalence in females. Both the weighted quantile sum and quantile g-computation models showed a significant positive correlation in the overall population and among females; however, this association was not observed in males. Bayesian kernel machine regression identified flavan-3-ols as a key contributor in females.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A U-shaped relationship was observed between total flavonoid intake and gallstone prevalence. Dietary flavonoids, particularly in females, are associated with the prevalence of gallstone, highlighting the need for further research into potential mechanism and consideration of sex in dietary guidelines.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03000605261466549","type":"journal-article","created":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T12:03:12Z","timestamp":1783771392000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["U-shaped association between dietary flavonoid and gallstone prevalence with sex-specific effects: Insights from a cross-sectional study"],"prefix":"10.1177","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8219-9089","authenticated-orcid":false,"given":"Jiaying","family":"Lin","sequence":"first","affiliation":[{"name":"Fujian Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Lin","sequence":"additional","affiliation":[{"name":"Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuquan","family":"Chen","sequence":"additional","affiliation":[{"name":"Mengchao Hepatobiliary Hospital of Fujian Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lihang","family":"Yang","sequence":"additional","affiliation":[{"name":"Fuzhou First General Hospital Affiliated with Fujian Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyan","family":"Xiu","sequence":"additional","affiliation":[{"name":"Fujian Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,11]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/apt.18486"},{"key":"e_1_3_3_3_2","article-title":"The multifaceted impact of gallstones: understanding complications and management strategies","volume":"16","author":"Gupta V","year":"2024","unstructured":"Gupta V, Abhinav A, Vuthaluru S, et al. The multifaceted impact of gallstones: understanding complications and management strategies. Cureus 2024; 16: e62500.","journal-title":"Cureus"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1055\/a-2378-9025"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2024.1481112"},{"key":"e_1_3_3_6_2","article-title":"GOLM1 promotes cholesterol gallstone formation via ABCG5-mediated cholesterol efflux in metabolic dysfunction-associated steatohepatitis livers","author":"Li Y-T","unstructured":"Li Y-T, Shao W-Q, Chen Z-M, et al. GOLM1 promotes cholesterol gallstone formation via ABCG5-mediated cholesterol efflux in metabolic dysfunction-associated steatohepatitis livers. 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