WBC as a mediator between TG/HDL Ratio and gallstone disease across gender differences: NHANES 2017–2020
Abstract
Gallstone
disease
(GSD)
is
associated
with
insulin
resistance
(IR)
and
systemic
inflammation,
yet
the
quantitative
relationships
among
these
factors
remain
underexplored.
This
study
investigates
association
between
IR
surrogate
indices
GSD,
a
focus
on
mediating
role
of
inflammation
potential
sex-based
differences.
Insulin
was
assessed
using
biomarkers
including
triglyceride-to-high-density
lipoprotein
cholesterol
(TG/HDL)
ratio,
TyG,
METS-IR,
HOMA-IR,
alongside
inflammatory
markers
such
as
white
blood
cell
(WBC).
The
TG/HDL
GSD
through
logistic
regression
models
restricted
cubic
spline
analysis.
Subgroup
analyses
were
conducted
based
age,
sex,
marital
status,
education,
poverty-to-income
ratio
(PIR)
body
mass
index
(BMI).
Furthermore,
key
analysis
to
investigate
WBC
in
relationship
incident
GSD.
Additionally,
interactions
sex
tested
both
multiplicative
additive
scales.
Among
3,624
included
participants,
those
diagnosed
gallstone
disease,
female-to-male
2.52:1.
highest
quartile
(Q4)
significantly
increased
risk
fully
adjusted
model
(OR
=
1.63;
95%
CI:
1.07–2.49;
P
0.022),
whereas
HOMA-IR
did
not
show
significant
associations
Q4
(all
>
0.05).
RCS
indicated
nonlinear,
reverse
L-shaped
(P
0.049).
Mediation
revealed
that
unadjusted
model,
count
mediated
accounting
for
28.6%
total
effect.
After
adjusting
partially
this
relationship,
explaining
17.2%
Interaction
demonstrated
interaction
<
0.05),
without
suggesting
heightened
females.
robustly
risk,
exhibiting
nonlinear
by
indexed
count.

Research Square (Research Square), Journal Year: 2025, Volume and Issue: unknown
Published: March 26, 2025
Language: Английский