Associations between lipid accumulation indices and gallstone prevalence in Chinese elderly: a community-based study in Fuzhou

This research focused on examining the association between lipid accumulation indices and the prevalence of gallstone disease among community-dwelling older adults in China, providing evidence for localized risk assessment. A cross-sectional study was conducted involving adults aged ≥ 60 years who underwent routine health check-ups at the Xiadu Street Community Health Service Center in Fuzhou City, Fujian Province, China, between January 2021 and December 2024. The analysis ultimately included 5,947 participants. Gallstones were diagnosed by abdominal ultrasonography. Four lipid accumulation indices were calculated: atherogenic index of plasma (AIP), cardiometabolic index (CMI), lipid accumulation product (LAP), and visceral adiposity index (VAI). Multivariable logistic regression models were used to evaluate the relationships between these indices and the risk of gallstones, with subgroup and sensitivity analyses conducted. Gallstones were detected in 708 participants (11.9%). In the fully adjusted model, LAP (per 10-unit increase, OR = 1.05, 95% CI: 1.02–1.07), VAI (OR = 1.05, 95% CI: 1.01–1.09), and CMI (OR = 1.18, 95% CI: 1.04–1.32) were significantly and positively associated with gallstone risk, with LAP showing the strongest association. AIP did not reach statistical significance after full adjustment (P = 0.064). Subgroup analyses indicated that these associations were consistent across gender, age, hypertension, and diabetes status (all interaction P > 0.05). Restricted cubic spline analyses suggested approximately linear dose-response relationships between the indices and gallstone risk. Sensitivity analyses employing multiple imputation produced results that were consistent with those in analyses that directly excluded the sample with missing covariates, suggesting robustness against missing data. Among community-dwelling older adults in China, LAP, VAI, and CMI are independently and positively associated with gallstone risk, with LAP demonstrating the most robust association. These easily obtainable composite lipid indices may serve as practical tools for early identification of individuals with higher likelihood of gallstones, informing targeted metabolic management and preventive strategies.