The Development and Evaluation of 9 Obesity-Based Index for Gallstones in U.S. Adults

Abstract

Objective: Gallstones have gradually become a highly prevalent digestive disease worldwide. This study aimed to investigate the association of nine different obesity-related indicators (BRI, WWI, BMI, WC, LAP, CMI, VAI, AIP, TyG) with gallstones and to compare their predictive properties for screening gallstones. Methods: Data for this study were obtained from the National Health and Nutrition Examination Survey (NHANES) for the 2017-2020 cycle, and weighted logistic regression analyses with multi-model adjustment were conducted to explore the association of the 9 indicators with gallstones. Subject working curves were analyzed to assess the screening ability of the 9 indicators. In addition, variation in the relationship between the two indicators with the most predictive power and gallstones was described by restricted cubic spline. Results: In total, 3698 participants were involved in the final analysis and 392 (10.6%) carried gallstones. The results of weighted multifactorial logistic regression analysis indicated that BRI, WWI, BMI, WC, LAP, and CMI were independent risk factors for gallstones. The ORs and confidence intervals for the highest quartile were 3.21 (1.55-6.28) for BRI, 2.26 (1.01-5.05) for WWI, 2.83 (1.48-5.39) for BMI, 2.83 (1.54-5.22) for WC, 2.39 (1.22-4.69) for LAP, 2.03 (1.19-3.46) for CMI. The area under the ROC curve for BRI was 0.67. The Delong test compared the performance of different ROCs and revealed that the difference between the area under the curve of BRI and the other metrics was significant (P<0.05), except for WWI. Conclusion: BRI, WWI, BMI, WC, LAP, and CMI were essential indicators for recognizing gallstones. By comparison, we realized that BRI was a better predictor of gallstones.