{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T11:28:32Z","timestamp":1792754912615,"version":"4.5.0"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,6,15]],"date-time":"2023-06-15T00:00:00Z","timestamp":1686787200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>We sought to evaluate the association between visceral adiposity index (VAI) and the incidence of gallstones and the age at first gallstone surgery in adults in the United States.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We selected individuals from the National Health and Nutrition Examination Survey (NHANES) database from 2017 to 2020 and evaluated the association between VAI and gallstone incidence and age at first gallstone surgery using logistic regression analysis, subgroup analysis, and dose\u2013response curves.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 7,409 participants aged &amp;gt;20 years were included in our study; 767 had a self-reported history of gallstones. After adjustment for all confounding factors, for each unit of VAI after Ln conversion, gallstone prevalence increased by 31% (OR = 1.31, 95% CI: 1.17, 1.48), while the first gallstone surgery was 1.97 years earlier (\u03b2 = \u22121.97, 95% CI: \u22123.35, \u22120.42). The dose\u2013response curves showed a positive correlation between VAI and gallstone prevalence. There was a negative correlation between increased VAI and age at first gallstone surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A higher VAI is positively associated with the prevalence of gallstones and may lead to an earlier age at first gallstone surgery. This is worthy of attention, although causality cannot be established.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2023.1189553","type":"journal-article","created":{"date-parts":[[2023,6,15]],"date-time":"2023-06-15T05:59:14Z","timestamp":1686808754000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":35,"title":["Higher visceral adiposity index was associated with an elevated prevalence of gallstones and an earlier age at first gallstone surgery in US adults: the results are based on a cross-sectional study"],"prefix":"10.3389","volume":"14","author":[{"given":"Gaopeng","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhe","family":"Ding","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junping","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianqi","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Tong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,6,15]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1016\/s0002-9610(05)80930-4","article-title":"Natural history of asymptomatic and symptomatic gallstones","volume":"165","author":"Friedman","year":"1993","journal-title":"Am J Surg"},{"key":"B2","doi-asserted-by":"publisher","first-page":"99","DOI":"10.2147\/CLEP.S37357","article-title":"Gallbladder cancer: epidemiology and outcome","volume":"6","author":"Hundal","year":"2014","journal-title":"Clin Epidemiol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.5009\/gnl.2012.6.2.172","article-title":"Epidemiology of gallbladder disease: cholelithiasis and cancer","volume":"6","author":"Stinton","year":"2012","journal-title":"Gut Liver"},{"key":"B4","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1186\/s12876-017-0678-6","article-title":"Sex and ethnic\/racial-specific risk factors for gallbladder disease","volume":"17","author":"Figueiredo","year":"2017","journal-title":"BMC Gastroenterol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpg.2006.05.004","article-title":"Gallstone disease: epidemiology of gallbladder stone disease","volume":"20","author":"Shaffer","year":"2006","journal-title":"Best Pract Res Clin Gastroenterol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2796.2007.01783.x","article-title":"Gallstone disease","volume":"261","author":"Marschall","year":"2007","journal-title":"J Intern Med"},{"key":"B7","article-title":"Gallstones and ethnicity in the americas","volume":"12","author":"Everhart","year":"2001","journal-title":"J Assoc Acad Minor Phys"},{"key":"B8","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1016\/j.gtc.2010.02.003","article-title":"Epidemiology of gallstones","volume":"39","author":"Stinton","year":"2010","journal-title":"Gastroenterol Clin North Am"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2016.03.005","article-title":"EASL clinical practice guidelines on the prevention, diagnosis and treatment of gallstones","volume":"65","year":"2016","journal-title":"J Hepatol"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a117403","article-title":"Epidemiology of gallstone disease in Italy: prevalence data of the multicenter Italian study on cholelithiasis (M.I.COL.)","volume":"141","author":"Attili","year":"1995","journal-title":"Am J Epidemiol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2018.08.025","article-title":"Claudin-3 regulates bile canalicular paracellular barrier and cholesterol gallstone core formation in mice","volume":"69","author":"Tanaka","year":"2018","journal-title":"J Hepatol"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1038\/srep29937","article-title":"The association between gallstones and metabolic syndrome in urban han Chinese: a longitudinal cohort study","volume":"6","author":"Zhu","year":"2016","journal-title":"Sci Rep"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2022.1025854","article-title":"Association of METS-IR index with prevalence of gallbladder stones and the age at the first gallbladder stone surgery in US adults: a cross-sectional study","volume":"13","author":"Wang","year":"2022","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B14","first-page":"9","article-title":"Non alcoholic fatty liver disease and metabolic syndrome","volume":"13","author":"Paschos","year":"2009","journal-title":"Hippokratia"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-015-0081-y","article-title":"Body mass index, abdominal fatness and the risk of gallbladder disease","volume":"30","author":"Aune","year":"2015","journal-title":"Eur J Epidemiol"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1097\/MEG.0b013e3283477cc9","article-title":"The aetiology of symptomatic gallstones quantification of the effects of obesity, alcohol and serum lipids on risk. epidemiological and biomarker data from a UK prospective cohort study (EPIC-Norfolk)","volume":"23","author":"Banim","year":"2011","journal-title":"Eur J Gastroenterol Hepatol"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1514009","article-title":"Mechanisms, pathophysiology, and management of obesity","volume":"376","author":"Heymsfield","year":"2017","journal-title":"N Engl J Med"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.121.318093","article-title":"Obesity, adipose tissue and vascular dysfunction","volume":"128","author":"Koenen","year":"2021","journal-title":"Circ Res"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(20)30110-8","article-title":"Causes, consequences, and treatment of metabolically unhealthy fat distribution","volume":"8","author":"Stefan","year":"2020","journal-title":"Lancet Diabetes Endocrinol"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaa823","article-title":"Pathophysiologic importance of visceral adipose tissue in women with heart failure and preserved ejection fraction","volume":"42","author":"Sorimachi","year":"2021","journal-title":"Eur Heart J"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.2337\/dc09-1825","article-title":"Visceral adiposity index: a reliable indicator of visceral fat function associated with cardiometabolic risk","volume":"33","author":"Amato","year":"2010","journal-title":"Diabetes Care"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1038\/oby.2011.38","article-title":"A better index of body adiposity","volume":"19","author":"Bergman","year":"2011","journal-title":"Obes (Silver Spring)"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-789X.2011.00952.x","article-title":"Waist-to-height ratio is a better screening tool than waist circumference and BMI for adult cardiometabolic risk factors: systematic review and meta-analysis","volume":"13","author":"Ashwell","year":"2012","journal-title":"Obes Rev"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2022.940905","article-title":"Relationship between hepatitis c and kidney stone in US females: results from the national health and nutrition examination survey in 2007-2018","volume":"10","author":"Chen","year":"2022","journal-title":"Front Public Health"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2022.978338","article-title":"Association between aldehyde exposure and kidney stones in adults","volume":"10","author":"Chen","year":"2022","journal-title":"Front Public Health"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1016\/S1665-2681(19)30765-3","article-title":"Gallstone disease and obesity: a population-based study on abdominal fat distribution and gender differences","volume":"14","author":"Radmard","year":"2015","journal-title":"Ann Hepatol"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.2174\/0929867324666170530080636","article-title":"The role of diet in the pathogenesis of cholesterol gallstones","volume":"26","author":"Di Ciaula","year":"2019","journal-title":"Curr Med Chem"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpg.2006.05.009","article-title":"Gallstone disease: epidemiology, pathogenesis, and classification of biliary stones (common bile duct and intrahepatic)","volume":"20","author":"Tazuma","year":"2006","journal-title":"Best Pract Res Clin Gastroenterol"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v18.i31.4215","article-title":"Metabolic syndrome and gallstone disease","volume":"18","author":"Chen","year":"2012","journal-title":"World J Gastroenterol"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1194\/jlr.M059121","article-title":"Estrogen induces two distinct cholesterol crystallization pathways by activating ER\u03b1 and GPR30 in female mice","volume":"56","author":"de Bari","year":"2015","journal-title":"J Lipid Res"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.4103\/0970-0218.91327","article-title":"Lifestyle and gallstone disease: scope for primary prevention","volume":"36","author":"Sachdeva","year":"2011","journal-title":"Indian J Community Med"},{"key":"B32","doi-asserted-by":"publisher","first-page":"17271","DOI":"10.1038\/s41598-020-74454-6","article-title":"Visceral adiposity index is associated with silent brain infarct in a healthy population","volume":"10","author":"Nam","year":"2020","journal-title":"Sci Rep"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1016\/s0016-5085(99)70456-7","article-title":"Prevalence and ethnic differences in gallbladder disease in the united states","volume":"117","author":"Everhart","year":"1999","journal-title":"Gastroenterol"},{"key":"B34","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1097\/01.mpg.0000187816.31213.06","article-title":"Prevalence of gallbladder stone disease in obese children and adolescents: influence of the degree of obesity, sex, and pubertal development","volume":"42","author":"Kaechele","year":"2006","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1001\/jama.293.3.330","article-title":"Effect of estrogen therapy on gallbladder disease","volume":"293","author":"Cirillo","year":"2005","journal-title":"JAMA"},{"key":"B36","doi-asserted-by":"publisher","first-page":"16024","DOI":"10.1038\/nrdp.2016.24","article-title":"Gallstones","volume":"2","author":"Lammert","year":"2016","journal-title":"Nat Rev Dis Primers"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.2444","article-title":"Prevalence of non-insulin-dependent diabetes mellitus among patients with cholelithiasis: a single-centered, cross-sectional study","volume":"10","author":"Ali","year":"2018","journal-title":"Cureus"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.2008.23.4.644","article-title":"Insulin resistance is associated with gallstones even in non-obese, non-diabetic Korean men","volume":"23","author":"Chang","year":"2008","journal-title":"J Korean Med Sci"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2022.920322","article-title":"An elevated METS-IR index is associated with higher asthma morbidity and earlier age of first asthma in US adults: results based on a cross-sectional study","volume":"13","author":"Chen","year":"2022","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2022.914812","article-title":"Is the METS-IR index a potential new biomarker for kidney stone development","volume":"13","author":"Shen","year":"2022","journal-title":"Front Endocrinol (Lausanne)"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2023.1189553\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,6,15]],"date-time":"2023-06-15T05:59:17Z","timestamp":1686808757000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2023.1189553\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,15]]},"references-count":40,"alternative-id":["10.3389\/fendo.2023.1189553"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2023.1189553","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,15]]},"article-number":"1189553"}}