The association between gallstone disease (GSD) and the incidence of prediabetes and type 2 diabetes mellitus (type 2 DM): a prospective cohort study

Abstract

The present study aimed to investigate the role of GSD in different phases of type 2 DM development in the Jinchang cohort study. A total of 28,760 eligible participants were divided into two mutually exclusive subgroups of normoglycemia (n = 23,725) and prediabetes (n = 5035) at baseline. These subgroups were followed up for incident prediabetes (n = 4512) and incident type 2 diabetes mellitus (n = 754), respectively. Cox proportional hazard models were used to determine hazard ratios (HRs) for incident prediabetes among normoglycemic individuals and incident type 2 diabetes mellitus among prediabetic individuals. The mean duration of follow-up was 2.18 years for incident prediabetes and 2.30 years for incident type 2 diabetes mellitus. GSD is significantly associated with incident type 2 diabetes mellitus among prediabetic individuals (HR = 1.292; 95% CI, 1.071–1.560), but not with incident prediabetes among normoglycemic individuals (HR = 0.999; 95% CI, 0.849–1.079). When gallstone and cholecystectomy were studied separately, only cholecystectomy was found to be significantly associated with incident type 2 diabetes mellitus among individuals with prediabetes (HR = 1.703; 95% CI, 1.299–2.233) and the association seems to be stronger in women (HR = 1.929; 95% CI, 1.242–2.994) than in men (HR = 1.555; 95% CI, 1.077–2.247). Our findings suggest that GSD is more closely related to the late-phase mechanisms in the development of type 2 DM than early-phase mechanisms.