{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T11:09:04Z","timestamp":1788952144369,"version":"build-2803163510"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"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. Nutr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Recent studies have linked individual lipid accumulation and triglyceride\u2013glucose indices to the prevalence of gallstones, but direct comparisons of metabolic, inflammatory, and immune\u2013nutritional indices in hospital-based health examination cohorts with ultrasonography-defined gallstones remain limited. We therefore examined whether routinely available composite indices were associated with prevalent gallstone disease and evaluated their cross-sectional discrimination performance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a single-center, hospital-based cross-sectional study of adults undergoing routine health examinations at the Health Examination Center of the Second Affiliated Hospital of Shandong First Medical University during 2024\u20132025. The primary inferential analyses included multivariable logistic regression models evaluating the associations between each candidate index and ultrasonography-detected gallstone disease. Quartile analyses, restricted cubic splines, ROC analyses, calibration, decision curve analysis, and explainable machine learning analyses were treated as exploratory. Stratified 5-fold cross-validation was used to assess internal model stability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 1,376 participants [mean (SD) age, 47.27 (13.35) years; 743 men (54.00%)], 127 (9.23%) had ultrasonography-detected gallstone disease. In Model 3, TyG-WC was nominally associated with gallstone disease per 1-SD increment (OR, 1.33; 95% CI, 1.05\u20131.69;\n                      <jats:italic>p<\/jats:italic>\n                      =\u202f0.017) and in Q4 versus Q1 (OR, 3.10; 95% CI, 1.38\u20136.96;\n                      <jats:italic>p<\/jats:italic>\n                      =\u202f0.006), although the quartile-specific CIs were wide. The CALLY index (OR per 1-SD, 0.62; 95% CI, 0.46\u20130.84;\n                      <jats:italic>p<\/jats:italic>\n                      =\u202f0.002), NLR (OR, 1.30; 95% CI, 1.09\u20131.55;\n                      <jats:italic>p<\/jats:italic>\n                      =\u202f0.004), and PNI (OR, 0.74; 95% CI, 0.61\u20130.91;\n                      <jats:italic>p<\/jats:italic>\n                      =\u202f0.004) remained significant after within-family false discovery rate (FDR) correction, whereas TyG-WC and CTI did not. TyG-WC had limited single-marker discrimination (AUC, 0.66; 95% CI, 0.61\u20130.71). Penalized logistic regression showed only modest internally validated discrimination (5-fold cross-validated AUC, 0.74; 95% CI, 0.69\u20130.78), with low precision\u2013recall performance.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Several routinely derived metabolic and immune\u2013nutritional indices were associated with prevalent ultrasonography-detected gallstone disease, but effect estimates were imprecise for some comparisons and discrimination was modest. The findings are hypothesis-generating; they do not establish incremental predictive value beyond conventional risk factors or support stand-alone clinical risk stratification without external and longitudinal validation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnut.2026.1879120","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T10:12:33Z","timestamp":1788948753000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Cross-sectional associations of lipid accumulation and immune\u2013nutritional indices with ultrasonography-detected gallstone disease: an explainable machine learning analysis"],"prefix":"10.3389","volume":"13","author":[{"given":"Lei","family":"Wang","sequence":"first","affiliation":[{"name":"Chongqing University Three Gorges Hospital","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Sun","sequence":"additional","affiliation":[{"name":"Qingdao Municipal Hospital, University of Health and Rehabilitation Sciences","place":["Qingdao, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cai","family":"Wang","sequence":"additional","affiliation":[{"name":"Binhai County People's Hospital","place":["Yancheng, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuantao","family":"Qi","sequence":"additional","affiliation":[{"name":"Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xue","family":"Gong","sequence":"additional","affiliation":[{"name":"Chongqing University Three Gorges Hospital","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"ref1","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":"ref2","doi-asserted-by":"publisher","first-page":"1586","DOI":"10.1016\/j.cgh.2024.01.051","article-title":"Global epidemiology of gallstones in the 21st century: a systematic review and meta-analysis","volume":"22","author":"Wang","year":"2024","journal-title":"Clin Gastroenterol Hepatol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"801","DOI":"10.1007\/s00535-023-02014-6","article-title":"Evidence-based clinical practice guidelines for cholelithiasis 2021","volume":"58","author":"Fujita","year":"2023","journal-title":"J 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