{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T06:05:19Z","timestamp":1780553119276,"version":"3.54.1"},"reference-count":47,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T00:00:00Z","timestamp":1780531200000},"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. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study aims to systematically investigate the association between the life's essential 8 (LE8) and gallstone disease (GSD), and further examine whether inflammation and oxidative stress mediate this relationship, so as to provide more scientific evidence for developing targeted preventive measures against GSD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a cross-sectional study utilizing baseline survey data from the China Multi-Ethnic Cohort (CMEC). Multivariate logistic regression and multiple linear regression models were employed to investigate the relationships among the LE8 score, inflammatory and oxidative stress biomarkers, and GSD. restricted cubic spline (RCS) regression analysis was employed to further investigate potential nonlinear relationships between LE8 and GSD. Additionally, the \u201cmediation\u201d package in R was utilized to determine whether the association between LE8 and GSD was mediated by inflammation and oxidative stress. Finally, subgroup and interaction analyses were conducted to understand the specific effects of LE8 on GSD across different populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      This study ultimately included 85,302 subjects with complete data. The overall prevalence of GSD was 7.26%. In a multivariate logistic regression model fully adjusted for age, gender, ethnicity, household registration, marital status, region, education level, and annual household income, the LE8 score showed a significant negative correlation with GSD risk (For each 10-point increase in LE8: OR = 0.833, 95% CI: 0.815\u20130.852,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001), and this association exhibited a significant nonlinear trend (\n                      <jats:italic>P<\/jats:italic>\n                      for nonlinear = 0.005). The results of the mediation analysis further indicated that the relationship between LE8 and GSD was partially mediated by inflammation and oxidative stress, with mediation proportions of 2.85 and 5.21%, respectively. Additionally, subgroup and interaction analyses indicated that the preventive effect of increased LE8 score on GSD was more pronounced in individuals under 50 years old, females, and those of Han ethnicity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Among the Chinese adult population, the LE8 score exhibited a significant nonlinear inverse dose-response relationship with GSD. This inverse association was partially mediated by improving the body's inflammatory and oxidative stress responses. These new findings contribute to developing novel and more targeted public health interventions for the prevention and management of GSD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1836977","type":"journal-article","created":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T05:40:10Z","timestamp":1780551610000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Better adherence to the life's essential 8 can reduce the risk of gallstone disease: mediated by inflammation and oxidative stress"],"prefix":"10.3389","volume":"14","author":[{"given":"Xinqiang","family":"Chen","sequence":"first","affiliation":[{"name":"School of Public Health, Kunming Medical University","place":["Kunming, China"]},{"name":"Zigong Center for Disease Control and Prevention","place":["Zigong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rudan","family":"Hong","sequence":"additional","affiliation":[{"name":"School of Public Health, Dali University, Dali","place":["Yunnan Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ran","family":"Liu","sequence":"additional","affiliation":[{"name":"School of Public Health, Kunming Medical University","place":["Kunming, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junmin","family":"Zhou","sequence":"additional","affiliation":[{"name":"West China School of Public Health and West China Fourth Hospital, Sichuan University","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuanwen","family":"Fu","sequence":"additional","affiliation":[{"name":"School of Public Health, Kunming Medical University","place":["Kunming, China"]},{"name":"Baoshan Center for Disease Control and Prevention","place":["Baoshan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia","family":"Zeng","sequence":"additional","affiliation":[{"name":"School of Public Health, Kunming Medical University","place":["Kunming, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianqin","family":"Zhong","sequence":"additional","affiliation":[{"name":"School of Public Health, Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University","place":["Guiyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liling","family":"Chen","sequence":"additional","affiliation":[{"name":"Chongqing Municipal Center for Disease Control and Prevention","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xunfu","family":"Zhong","sequence":"additional","affiliation":[{"name":"Wuhou District Center for Disease Control and Prevention","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yangji","family":"Baima","sequence":"additional","affiliation":[{"name":"School of Medicine, Tibet University","place":["Lasa, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhuohang","family":"Che","sequence":"additional","affiliation":[{"name":"School of Public Health, Kunming Medical University","place":["Kunming, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Qian","sequence":"additional","affiliation":[{"name":"School of Public Health, Kunming Medical University","place":["Kunming, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiong","family":"Meng","sequence":"additional","affiliation":[{"name":"School of Public Health, Kunming Medical University","place":["Kunming, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianzhong","family":"Yin","sequence":"additional","affiliation":[{"name":"School of Public Health, Kunming Medical University","place":["Kunming, China"]},{"name":"School of Public Health, Dali University, Dali","place":["Yunnan Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,4]]},"reference":[{"key":"B1","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":"B2","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":"B3","doi-asserted-by":"publisher","first-page":"146","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":"B4","doi-asserted-by":"publisher","first-page":"621","DOI":"10.1053\/j.gastro.2021.10.017","article-title":"Burden and cost of gastrointestinal, liver, and pancreatic diseases in the United States: update 2021","volume":"162","author":"Peery","year":"2022","journal-title":"Gastroenterology."},{"key":"B5","doi-asserted-by":"publisher","first-page":"1864","DOI":"10.1038\/s41416-021-01325-w","article-title":"Causal effects of gallstone disease on risk of gastrointestinal cancer in Chinese","volume":"124","author":"Pang","year":"2021","journal-title":"Br J Cancer."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1069","DOI":"10.1038\/s41416-022-01877-5","article-title":"Gallstones and risk of cancers of the liver, biliary tract and pancreas: a prospective study within two US cohorts","volume":"127","author":"Luo","year":"2022","journal-title":"Br J Cancer."},{"key":"B7","doi-asserted-by":"publisher","first-page":"1744","DOI":"10.1111\/liv.14456","article-title":"Screen-detected gallstone disease and risk of liver and pancreatic cancer: the Kailuan cohort study","volume":"40","author":"Zhao","year":"2020","journal-title":"Liver Int."},{"key":"B8","doi-asserted-by":"publisher","first-page":"218","DOI":"10.1053\/j.gastro.2023.03.227","article-title":"Gallstones, cholecystectomy, and kidney cancer: observational and mendelian randomization results based on large cohorts","volume":"165","author":"Kharazmi","year":"2023","journal-title":"Gastroenterology."},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.3390\/biom12040550","article-title":"Factors influencing gallstone formation: a review of the literature","author":"Sun","year":"2022","journal-title":"Biomolecules."},{"key":"B10","doi-asserted-by":"publisher","first-page":"1138","DOI":"10.1002\/hep.20654","article-title":"Genetic and environmental influences on symptomatic gallstone disease: a Swedish study of 43,141 twin pairs","volume":"41","author":"Katsika","year":"2005","journal-title":"Hepatology."},{"key":"B11","doi-asserted-by":"publisher","first-page":"1469789","DOI":"10.3389\/fnut.2024.1469789","article-title":"Dietary patterns, genetic predisposition, and risk of cholelithiasis: a large-scale prospective cohort study","volume":"11","author":"Jin","year":"2024","journal-title":"Front Nutr."},{"key":"B12","doi-asserted-by":"publisher","first-page":"e18","DOI":"10.1161\/CIR.0000000000001078","article-title":"Life's essential 8: updating and enhancing the american heart association's construct of cardiovascular health: a presidential advisory from the american heart association","volume":"146","author":"Lloyd-Jones","year":"2022","journal-title":"Circulation."},{"key":"B13","doi-asserted-by":"publisher","first-page":"649","DOI":"10.1001\/jamacardio.2025.0630","article-title":"Cumulative life's essential 8 scores and cardiovascular disease risk","volume":"10","author":"Walker","year":"2025","journal-title":"JAMA Cardiol."},{"key":"B14","doi-asserted-by":"publisher","first-page":"340","DOI":"10.1001\/jamainternmed.2023.0015","article-title":"Association of cardiovascular health with life expectancy free of cardiovascular disease, diabetes, cancer, and dementia in UK adults","volume":"183","author":"Wang","year":"2023","journal-title":"JAMA Intern Med."},{"key":"B15","doi-asserted-by":"publisher","first-page":"e0312857","DOI":"10.1371\/journal.pone.0312857","article-title":"Associations between life's essential 8 and gallstones among us adults: a cross-sectional study from NHANES 2017\u20132018","volume":"19","author":"Wang","year":"2024","journal-title":"PLoS ONE."},{"key":"B16","doi-asserted-by":"publisher","first-page":"4713","DOI":"10.1038\/s41598-025-89024-x","article-title":"The association between life's essential 8 and gallstones: a cross-sectional study","volume":"15","author":"Zhao","year":"2025","journal-title":"Sci Rep."},{"key":"B17","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1097\/MOG.0000000000000423","article-title":"An update on the pathogenesis of cholesterol gallstone disease","volume":"34","author":"Di Ciaula","year":"2018","journal-title":"Curr Opin Gastroenterol."},{"key":"B18","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1016\/j.bbi.2019.04.041","article-title":"Lifestyle and biological factors influence the relationship between mental health and low-grade inflammation","volume":"85","author":"Gialluisi","year":"2020","journal-title":"Brain Behav Immun."},{"key":"B19","doi-asserted-by":"publisher","first-page":"101869","DOI":"10.1016\/j.redox.2021.101869","article-title":"Dietary patterns and biomarkers of oxidative stress and inflammation: a systematic review of observational and intervention studies","volume":"42","author":"Aleksandrova","year":"2021","journal-title":"Redox Biol."},{"key":"B20","doi-asserted-by":"publisher","first-page":"721","DOI":"10.1093\/ije\/dyaa185","article-title":"Cohort profile: the china multi-ethnic cohort (CMEC) study","volume":"50","author":"Zhao","year":"2021","journal-title":"Int J Epidemiol."},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.3390\/nu15214539","article-title":"Fish intake in relation to fatal and non-fatal cardiovascular risk: a systematic review and meta-analysis of cohort studies","author":"Ricci","year":"2023","journal-title":"Nutrients."},{"key":"B22","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1016\/j.jshs.2023.10.010","article-title":"2024 Adult compendium of physical activities: a third update of the energy costs of human activities","volume":"13","author":"Herrmann","year":"2024","journal-title":"J Sport Health Sci."},{"key":"B23","doi-asserted-by":"publisher","first-page":"2158","DOI":"10.1002\/cncr.30057","article-title":"A novel systemic inflammation response index (SIRI) for predicting the survival of patients with pancreatic cancer after chemotherapy","volume":"122","author":"Qi","year":"2016","journal-title":"Cancer."},{"key":"B24","doi-asserted-by":"publisher","first-page":"119470","DOI":"10.1016\/j.jad.2025.119470","article-title":"Associations of metabolic syndrome with depression are mediated by inflammation and oxidative stress: findings from NHANES 2005\u20132018","volume":"386","author":"Li","year":"2025","journal-title":"J Affect Disord."},{"key":"B25","doi-asserted-by":"publisher","first-page":"148","DOI":"10.3238\/arztebl.2020.0148","article-title":"The treatment of gallstone disease","volume":"117","author":"Gutt","year":"2020","journal-title":"Dtsch Arztebl Int."},{"key":"B26","doi-asserted-by":"publisher","first-page":"116715","DOI":"10.1016\/j.socscimed.2024.116715","article-title":"A situational test of the health belief model: How perceived susceptibility mediates the effects of the environment on behavioral intentions","volume":"346","author":"Taflinger","year":"2024","journal-title":"Soc Sci Med."},{"key":"B27","doi-asserted-by":"publisher","first-page":"623","DOI":"10.1037\/hea0000728","article-title":"A meta-analysis of the health action process approach","volume":"38","author":"Zhang","year":"2019","journal-title":"Health Psychol."},{"key":"B28","doi-asserted-by":"publisher","first-page":"619","DOI":"10.1007\/s40279-025-02373-5","article-title":"Goal setting in exercise and physical activity: an expert statement on behalf of exercise and sports science Australia","volume":"56","author":"Swann","year":"2026","journal-title":"Sports Med."},{"key":"B29","doi-asserted-by":"publisher","first-page":"546","DOI":"10.1080\/10520295.2022.2036813","article-title":"Cholesterol crystals activate NLRP3 inflammasomes and promote gallstone formation by increasing mucin secretion","volume":"97","author":"Lei","year":"2022","journal-title":"Biotech Histochem."},{"key":"B30","doi-asserted-by":"publisher","first-page":"676","DOI":"10.3390\/biom14060676","article-title":"Role of secretory mucins in the occurrence and development of cholelithiasis","volume":"14","author":"Zhao","year":"2024","journal-title":"Biomolecules."},{"key":"B31","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1186\/s10020-023-00712-8","article-title":"AQP3-mediated activation of the AMPK\/SIRT1 signaling pathway curtails gallstone formation in mice by inhibiting inflammatory injury of gallbladder mucosal epithelial cells","volume":"29","author":"Wang","year":"2023","journal-title":"Mol Med."},{"key":"B32","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1080\/1025814021000036179","article-title":"Evidence for oxidative stress in the gall bladder mucosa of gall stone patients","volume":"6","author":"Geetha","year":"2002","journal-title":"J Biochem Mol Biol Biophys."},{"key":"B33","doi-asserted-by":"publisher","first-page":"1497068","DOI":"10.3389\/fimmu.2024.1497068","article-title":"Association between complete blood cell count-derived inflammatory biomarkers and gallstones prevalence in American adults under 60 years of age","volume":"15","author":"Fu","year":"2024","journal-title":"Front Immunol."},{"key":"B34","doi-asserted-by":"publisher","first-page":"1681","DOI":"10.1093\/advances\/nmab037","article-title":"The dietary inflammatory index and human health: an umbrella review of meta-analyses of observational studies","volume":"12","author":"Marx","year":"2021","journal-title":"Adv Nutr."},{"key":"B35","doi-asserted-by":"publisher","first-page":"8713","DOI":"10.3390\/ijms23158713","article-title":"Effect of physical activity\/exercise on oxidative stress and inflammation in muscle and vascular aging","volume":"23","author":"El","year":"2022","journal-title":"Int J Mol Sci."},{"key":"B36","doi-asserted-by":"publisher","first-page":"101455","DOI":"10.1016\/j.redox.2020.101455","article-title":"Waterpipe (shisha, hookah) smoking, oxidative stress and hidden disease potential","volume":"34","author":"Badran","year":"2020","journal-title":"Redox Biol."},{"key":"B37","doi-asserted-by":"publisher","first-page":"12286","DOI":"10.1038\/s41598-021-91510-x","article-title":"Fourteen days of smoking cessation improves muscle fatigue resistance and reverses markers of systemic inflammation","volume":"11","author":"Darabseh","year":"2021","journal-title":"Sci Rep."},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.3390\/ijms26146731","article-title":"Melatonin as the missing link between sleep deprivation and immune dysregulation: a narrative review","author":"Szataniak","year":"2025","journal-title":"Int J Mol Sci."},{"key":"B39","doi-asserted-by":"publisher","first-page":"7898","DOI":"10.3390\/ijms24097898","article-title":"Mechanisms of oxidative stress in metabolic syndrome","volume":"24","author":"Masenga","year":"2023","journal-title":"Int J Mol Sci."},{"key":"B40","doi-asserted-by":"publisher","first-page":"2945","DOI":"10.1007\/s11357-025-01839-8","article-title":"Effects of resistance-based training and polyphenol supplementation on physical function, metabolism, and inflammation in aging individuals","volume":"48","author":"Flensted-Jensen","year":"2025","journal-title":"Geroscience."},{"key":"B41","doi-asserted-by":"publisher","first-page":"1589","DOI":"10.3748\/wjg.v29.i10.1589","article-title":"Gastrointestinal microbiome and cholelithiasis: current status and perspectives","volume":"29","author":"Dan","year":"2023","journal-title":"World J Gastroenterol."},{"key":"B42","doi-asserted-by":"publisher","first-page":"559","DOI":"10.1055\/s-0034-1376969","article-title":"Serum adiponectin and progranulin levels are associated with gallstone disease","volume":"122","author":"Breitfeld","year":"2014","journal-title":"Exp Clin Endocrinol Diabetes."},{"key":"B43","doi-asserted-by":"publisher","first-page":"e0274659","DOI":"10.1371\/journal.pone.0274659","article-title":"Risk factors for gallstone disease onset in Japan: findings from the Shizuoka Study, a population-based cohort study","volume":"17","author":"Higashizono","year":"2022","journal-title":"PLoS ONE."},{"key":"B44","doi-asserted-by":"publisher","first-page":"735","DOI":"10.21037\/atm-21-6186","article-title":"Age, gender, geographic and clinical differences for gallstones in China: a nationwide study","volume":"10","author":"Song","year":"2022","journal-title":"Ann Transl Med."},{"key":"B45","doi-asserted-by":"publisher","first-page":"1931","DOI":"10.1093\/ije\/dyac036","article-title":"Genetically predicted sex hormone levels and health outcomes: phenome-wide Mendelian randomization investigation","volume":"51","author":"Yuan","year":"2022","journal-title":"Int J Epidemiol."},{"key":"B46","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1186\/s12876-021-01677-w","article-title":"Epidemiological survey to determine the prevalence of cholecystolithiasis in Uyghur, Kazakh, and Han ethnic groups in the Xinjiang Uyghur autonomous region of China: cross-sectional studies","volume":"21","author":"Lv","year":"2021","journal-title":"BMC Gastroenterol."},{"key":"B47","doi-asserted-by":"publisher","first-page":"3503","DOI":"10.1186\/s12889-024-21071-x","article-title":"Association of neutrophil percentage to albumin ratio with gallstones: a cross-sectional study from the United States NHANES","volume":"24","author":"Wang","year":"2024","journal-title":"BMC Public Health."}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1836977\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T05:40:11Z","timestamp":1780551611000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1836977\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,4]]},"references-count":47,"alternative-id":["10.3389\/fpubh.2026.1836977"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1836977","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,4]]},"article-number":"1836977"}}