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基于纵向研究的胆囊结石发病风险因素研究新进展

New Progress in Longitudinal Research on the Risk Factors for Cholelithiasis

  • 摘要: 胆囊结石是常见的消化系统疾病。已有多篇文献对胆囊结石发病风险因素进行了报道和归纳,但是其纳入的研究主要为横断面设计,因其研究设计的固有缺陷,研究结果有待更多纵向研究进行验证。而且近年来多项研究陆续发现了多个新的胆囊结石风险因素,如减肥手术、乙肝病毒感染、丙肝病毒感染、肾结石、结肠切除术、骨质疏松等因素,但未被纳入既往综述研究中。本研究对基于纵向研究(队列、随机对照试验和巢式病例对照)发现的101个胆囊结石发病相关风险因素进行综述,将胆囊结石发病相关风险因素归纳为不可调控因素和可调控因素。其中不可调控因素包括年龄、性别、种族和家族史4个因素,而可调控因素包括37个生物环境因素、25个社会环境因素和35个理化环境因素。本研究可为胆囊结石的发病机制研究提供全面和综合的线索,为胆囊结石发病高危人群识别和预防策略的制定提供基础。

     

    Abstract: Cholelithiasis is a common disease of the digestive system. The risk factors for cholelithiasis have been reported and summarized many times in the published literature, which primarily focused on cross-sectional studies. Due to the inherent limitations of the study design, the reported findings still need to be validated in additional longitudinal studies. Moreover, a number of new risk factors for cholelithiasis have been identified in recent years, such as bariatric surgery, hepatitis B virus infection, hepatitis C virus infection, kidney stones, colectomy, osteoporosis, etc. These new findings have not yet been included in published reviews. Herein, we reviewed the 101 cholelithiasis-associated risk factors identified through research based on longitudinal investigations, including cohort studies, randomized controlled trials, and nested case control studies. The risk factors associated with the pathogenesis of cholelithiasis were categorized as unmodifiable and modifiable factors. The unmodifiable factors consist of age, sex, race, and family history, while the modifiable factors include 37 biological environmental factors, 25 socioenvironmental factors, and 35 physiochemical environmental factors. This study provides thorough and comprehensive ideas for research concerning the pathogenesis of cholelithiasis, supplying the basis for identifying high-risk groups and formulating relevant prevention strategies.

     

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