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

Background Gallstone disease (GSD) is a major global public health concern. Although prolonged sedentary behavior and poor cardiovascular health (CVH) may contribute to GSD development, prospective evidence evaluating their independent and joint associations with incident GSD remains limited. Therefore, we aimed to examine the associations of sedentary time and CVH, assessed by the Life’s Essential 8 (LE8), with incident GSD in a large prospective cohort. Methods This prospective cohort study included 307,059 participants from UK Biobank who were free of GSD at baseline. 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. Results During a median follow-up of 7.39 years, 10,919 participants developed GSD. In fully adjusted models, each 1-hour increase in sedentary time was associated with a 7% higher risk of incident GSD (HR = 1.07, 95% CI: 1.06–1.08), whereas each 10-point increase in LE8 score was associated with a 21% lower risk (HR = 0.79, 95% CI: 0.78–0.80). Compared with participants in the lowest sedentary time tertile, those in the high tertile had a 56% higher GSD risk (HR = 1.56, 95% CI: 1.49–1.64). Participants with low CVH had a 2.48-fold higher GSD risk than those with high CVH (HR = 2.48, 95% CI: 2.28–2.71). Importantly, compared with participants with low sedentary time and high CVH, those with high sedentary time and low CVH exhibited the highest GSD risk (HR = 3.44, 95% CI: 3.04–3.90). Conclusions Prolonged sedentary time and poor CVH were independently and 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.