Abstract
BACKGROUND: Current evidence from cohort studies on the association between metabolic dysfunction-associated fatty liver disease (MAFLD) and gallstone formation remains limited. This 5-year retrospective cohort study aimed to evaluate the impact of MAFLD on gallstone incidence among railway safety staff. METHODS: Data were obtained from the physical examination data of railway safety staff at Wuchang Hospital, Wuhan City, Hubei Province, China. The diagnosis of MAFLD was consistent with the international expert consensus. Independent associations between MAFLD and participants' risk of gallstone incidence were assessed by multiple Cox regression. Stratified analyses and interaction tests were performed to investigate whether covariates modified the association between MAFLD and gallstone incidence. RESULTS: Among 1,422 participants, the risk of gallstone incidence was 9.27% (37/399) higher in the exposed group with MAFLD than in the control group 5.67% (58/1,023). Multiple cox regression showed that people with MAFLD were associated with a risk of gallstone incidence (HR = 1.71, 95% CI = 1.13-2.58). Stratified analysis by sex showed that men with MAFLD had a significantly increased risk (HR = 1.54, 95% CI: 1.00-2.38, P = 0.050), whereas women did not reach statistical significance (P = 0.605), but the sex interaction was not significant (P-interaction = 0.664). In age-stratified analyses, both the 45-60 years group (HR = 1.58, P = 0.078) and the 30-45 years group (HR = 1.89, P = 0.179) showed a trend toward increased risk, but the interaction was not statistically different (P-interaction = 0.270). CONCLUSIONS: There is a significant association between MAFLD and the incidence of gallstones. Attention should be paid to the prevention and treatment of MAFLD to promote the health of railway safety staff and reduce the burden ofanalysis gallstone-related diseases.