OUP accepted manuscript

Studies have suggested that adults with gallbladder disease have increased risk of type 2 diabetes. This prospective cohort study assesses the risk of type 2 diabetes in postmenopausal women with gallbladder disease. Data from women aged 50-79 years (Mean 63.2, SD 7.2) enrolled in the Women's Health Initiative from 1993 to 2005 was analyzed. Cox proportional hazards regression models estimated the risk of type 2 diabetes associated with gallbladder disease. There were 8,896 new cases of type 2 diabetes after 1,025,486 person-years of follow-up. Gallbladder disease was significantly associated with type 2 diabetes (HR 1.52, 95% CI: 1.38,1.67). The observed risk of type 2 diabetes in women with both gallbladder disease and central obesity was 37% higher than expected (RERI 0.37, 95% CI: 0.11,0.63). The hazard ratios for type 2 diabetes associated with gallbladder disease was 1.25 (95% CI: 1.19,1.32) and 1.48 (95% CI: 1.34,1.63) in women with and without central obesity, respectively. Results of this study support further studies to determine whether interventions in older women with gallbladder disease would reduce type 2 diabetes risk, especially among those with central obesity. Future research should examine the pathophysiologic basis of the association between gallbladder disease and type 2 diabetes.