Cohort Study On The Relationship Between Gallbladder Disease And Cardiovascular Disease Risk Among Uyghurs In Corps Of Xinjiang

Objective:In this study,the Uygur population of Xinjiang Corps was taken as the research object,and the prevalence of gallbladder disease(GBD)in this area was described.The characteristics of cardiovascular disease(CVD)and the relationship between GBD and CVD risk were explored through prospective cohort study.Subgroup analysis was used to further evaluate the risk characteristics of GBD and CVD.To explore the influence of the interaction between GBD and CVD traditional cardiac metabolic risk factors on the risk of CVD,and to provide reference for the prevention and treatment of CVD in Uygur population.Methods:In this study,a prospective cohort study was conducted using the typical sampling method to select the Uyghur population of the 51 st regiment in the Third Division of Xinjiang Production and Construction Corps as the research object.A baseline survey was conducted from August to September 2016,and three follow-up visits were conducted in 2019,2020,and 2021.A total of 14,321 study participants were included in the study,and 1527 participants were excluded due to incomplete information,severe illness,unconsciousness,inability to cooperate,unwillingness,pregnancy,and transient population.A further 1064 participants with existing CVD(ischaemic heart diseases(IHD),pulmonary embolism,cerebrovascular diseases,peripheral vascular disease,etc.)were also excluded.286 people were lost to follow-up.The final cohort consisted of 11,444 study participants,included in the longitudinal analysis;the follow-up rate was97.56%.The chi-square test was used to compare categorical variables,and the Mann–Whitney U test was used to compare differences between groups in continuous variables.The Kaplan–Meier method was used to estimate the cumulative incidence of CVD events.Hazard ratios(HRs)and 95% confidence intervals(CIs)for CVD occurrence were estimated using the Cox hazards proportional model.A multivariable model for CVD was constructed using stepwise regression.This included variables significantly associated with the occurrence of CVD in univariate analysis and known traditional risk factors for CVD.A likelihood ratio test was used to determine whether the added variables significantly improved the model using a significance threshold of P <0.05.The risk characteristics of GBD and CVD were further evaluated by subgroup analysis.The interaction between GBD and cardiometabolic risk factors,and subsequent risk of developing CVD,was evaluated.Results:1.GBD disease characteristics: the final cohort consisted of 11,444 study participants,included in the longitudinal analysis;The baseline GBD prevalence was 10.29%;6.04% in males and 14.77% in females.2.CVD incidence: after a median follow-up of 4.92 years,1200 study subjects had a new CVD event with a cumulative incidence of 10.49%,8.43% for men and 12.65% for women.The incidence density of CVD in GBD group was 821.22/10000 person-years,and the cumulative incidence rate was 34.04%.The incidence density of CVD in non-GBD group was 164.92/10000 person-years,and the cumulative incidence rate was 7.78%.The risk of CVD in GBD group was significantly higher than that in non-GBD group(HR = 4.96,95% CI: 4.40-5.59).3.Influencing factors analysis: sex,age,smoking,drinking,exercise,hypertension,T2 DM,dyslipidaemia,overweight,abdominal obesity,TG levels,TC levels,LDL levels,and HDL levels were all strongly associated with CVD by univariate Cox regression analysis(P<0.05).Further stepwise forward regression analysis using Cox regression analysis showed that sex,age,exercise,hypertension,T2 DM,overweight,and HDL levels all independently influenced the occurrence of CVD(p<0.05).After the multivariate adjustment,the risk of developing CVD was still higher in the GBD group than in the nonGBD group(HR=2.89,95% CI: 2.54-3.28).4.Subgroup analysis: the risk of CVD was significantly higher in the GBD group than in the non-GBD group in all subgroups.Moreover,in the GBD group,being male,smoking,drinking,lack of exercise,abnormal renal function and high levels of TG,TC,and LDL,and low levels of HDL had a higher risk of CVD.5.Transactional analysis between GBD and risk factors of cardiac metabolism: after adjusting confounding factors,the group without GBD and risk factors of cardiac metabolism was taken as the control group,and the risk of CVD in each group was:(1)GBD+ hypertension group > GBD+ nonhypertension group > non-GBD+ hypertension group,with HR of 5.58(95% CI: 4.71-6.62)> 2.65(95% CI:2.19-3.23)> 1.82(95% CI: 1.58-2.21)respectively.(2)GBD+ T2 DM group > GBD+ non-T2 DM group >non-GBD+ T2 DM group,with HR of 3.50(95%CI: 2.68-4.56)> 3.21(95%CI: 2.80-3.69)> 2.12(95%CI:1.74-2.58)respectively.(3)There was no statistical significance between the group non-GBD+dyslipidemia and the risk of CVD(HR 1.10,95%CI: 0.94-1.28),but the GBD+ non-dyslipidemia group >GBD+ dyslipidemia group,with HR of 3.00(95%CI: 2.54-3.56)> 2.98(95%CI: 2.46-3.60).(4)GBD+overweight group > GBD+ non-overweight group > non-GBD+ overweight group,with HR of 4.05(95%CI:3.35-4.89)> 3.41(95%CI: 2.60-4.47)> 1.27(95%CI: 1.24-1.73)respectively.(5)GBD+ non-abdominal obesity group > GBD+ abdominal obesity group > non-GBD+ abdominal obesity group,with HR of 4.28(95%CI: 3.24-5.65)> 3.30(95%CI: 2.68-4.06)> 1.25(95%CI: 1.04-1.50)respectively.Conclusions:1.The prevalence of GBD in rural Uighurs in Xinjiang is high(10.29%)and the prevalence of GBD in females(14.77%)is higher than that in males(6.04%).2.The incidence of CVD in Xinjiang Uygur population is 10.49%,and female(12.65%)is higher than male(8.43%).The cumulative incidence of CVD in GBD group was 34.04% higher than that in non-GBD group(7.78%).After adjusting for confounding factors,the risk of CVD in GBD group was still 2.89 times higher than that in non-GBD group(HR = 2.89,95% CI: 2.54-3.28).3.Among Uighurs with GBD,male,smoking,drinking,lack of exercise,abnormal renal function,high levels of TG,TC,LDL and low levels of HDL are at higher risk of CVD.4.The risk of CVD caused by GBD combined with cardiac metabolic risk factors is higher than that caused by cardiac metabolic risk factors alone,and they have synergistic effect in promoting CVD.