Linear relationship between percentage-based waist-to-height ratio and the risk of gallstones among US adults: A cross-sectional study from NHANES 2017 to 2020

The influence of obesity on the formation of gallstones has been extensively studied. The waist-to-height ratio (WHtR) is an effective tool for assessing body fat and obesity levels. This study aimed to investigate the linear correlation between percentage-based WHtR and gallstone prevalence. Data from 7731 participants in the National Health and Nutrition Examination Survey from 2017 to 2020 were used in this cross-sectional study. Weighted logistic regression, trend tests, restricted cubic splines (RCS), subgroup and interaction analyses were employed to evaluate the association between WHtR and gallstones. In the fully adjusted logistic regression model, each 1% increase in WHtR was associated with a 4.3% increase in the risk of gallstones (odds ratio = 1.043, 95% confidence interval: 1.034-1.052). Compared to the lowest quartile of WHtR, the highest quartile had a 201.5% increased risk of gallstones (odds ratio = 3.015, 95% confidence interval: 2.239-4.061), demonstrating a dose-response relationship (P for trend < .01). RCS indicate a positive linear relationship between WHtR and the odds of gallstones (P for nonlinear = .297). The association between WHtR and gallstone risk persisted in subgroup analyses. Interaction analyses showed that age and gender have an interactive effect on the association. There was a positive linear relationship between WHtR based on percentage and the prevalence of gallstones, displaying a dose-response relationship. Maintaining an appropriate WHtR may reduce the risk of gallstones.