Associations of sedentary time and cardiovascular health with gallstone disease: evidence from a prospective cohort study

Prolonged sedentary time and poor cardiovascular health (CVH) may be associated with gallstone disease (GSD). However, prospective evidence evaluating their joint associations with incident GSD remains limited. We aimed to examine the individual and joint associations of sedentary time and CVH, assessed using Life’s Essential 8 (LE8), with incident GSD. This prospective cohort study included 307,919 participants from UK Biobank who were free of GSD at baseline. Sedentary time was assessed using self-reported time spent watching television, using a computer outside of work, and driving. CVH was evaluated using the LE8 score. Multivariable Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Joint associations were assessed using a nine-category variable combining sedentary time tertiles and CVH categories. During a median follow-up of 13.73 years, 10,911 participants developed GSD. In fully adjusted models, each 1-hour increase in sedentary time was associated with a higher risk of incident GSD (HR = 1.08, 95% CI: 1.07–1.08), whereas each 10-point increase in LE8 score was associated with a lower risk (HR = 0.78, 95% CI: 0.77–0.79). Compared with participants in the lowest sedentary time tertile, those in the high tertile had a 59% higher GSD risk (HR = 1.59, 95% CI: 1.51–1.67). Similarly, participants with low CVH had a 2.80-fold higher GSD risk than those with high CVH (HR = 2.80, 95% CI: 2.58–3.05). In the joint analysis, compared with participants with low sedentary time and high CVH, those with high sedentary time and low CVH exhibited the highest GSD risk (HR = 3.84, 95% CI: 3.39–4.35). Longer sedentary time and poorer CVH were jointly associated with an increased risk of incident GSD. These findings underscore the potential importance of reducing sedentary behavior and improving overall CVH for GSD prevention.