American Journal of Epidemiology Vol. 147, No. 7: 644-651
Copyright © 1998 by The Johns Hopkins University School of Hygiene and Public Health
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Body Mass Index, Cigarette Smoking, and Other Characteristics as Predictors of Self-Reported, Physician-Diagnosed Gallbladder Disease in Male College Alumni
1 Department of Public Health, University of Helsinki Helsinki, Finland
2 Division of Epidemiology, Stanford University School of Medicine Stanford, CA
3 Department of Epidemiology, Harvard School of Public Health Boston, MA
4 Cancer Center, University of Massachusetts Medical Center Worcester, MA
5 Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School Boston, MA
Reprint requests to Dr. Timo Sahi, Kappatie 1, 00420 Helsinki, Finland.
Despite the high prevalence of gallbladder disease in industrialized countries, little is known about the predictors of the disease, especially in men. The authors prospectively studied 16,785 alumni of Harvard University, aged 15–24 years, who were followed for up to 61 years. The health characteristics of these men were ascertained from their college entrance physical examination done in 1916–1950, and updated via mailed questionnaires in 1962 or 1966 (1962/1966). Alumni subsequently self-reported physician-diagnosed gallbladder disease on further mailed questionnaires in 1972 or 1977. Between college time and 1962/1966, 371 gallbladder disease cases occurred. An additional 314 cases occurred after 1962/1966. With respect to college characteristics, after adjustment for potential confounders, the authors found that body mass index (BMI), smoking, physical activity, blood pressure, and consumption of alcohol, coffee, or tea were unrelated to risk. However, BMI in 1962/1966 was directly related to risk of subsequent gallbladder disease, as was BMI gain since college (p, trend = 0.002 and 0.013, respectively). Compared with men with BMI <22.0, men with BMI 
27.0 had a rate ratio of 2.71 (95% confidence interval (CI) 1.57–4.66) for risk of contracting the disease. Men who gained 6.0 BMI units since college had a rate ratio of 1.46 (95% CI 0.86–2.46) compared with men who gained –0.9 to +0.9 BMI units. Compared with never smokers, men who smoked pipes or cigars or <1 pack of cigarettes daily in 1962/1966 had a rate ratio of 1.43 (95% CI 1.00–2.06), while heavier cigarette smokers had a rate ratio of 1.52 (95% CI 1.03–2.24). Neither physical activity nor physician-diagnosed hypertension or diabetes mellitus in 1962/1966 predicted risk. Am J Epidemiol 1998; 147: 644–51.
cholelithiasis; gallbladder diseases; obesity; physical activity; smoking
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