The association between gout and nephrolithiasis: The National Health and Nutrition Examination Survey III, 1988-1994
The association between gout and nephrolithiasis: The National Health and Nutrition Examination Survey III, 1988-1994
复制标题
DOI：
10.1053/ajkd.2002.33911
复制
发表时间：
2002-07-01
影响因子：
13.2
通讯作者：
Curhan, G
中科院分区：
文献类型：
--
作者：
Kramer, HM;Curhan, G
背景：痛风是一种炎症性关节炎，据报道，在美国有200多万男性和女性患有痛风。以前的报告表明痛风和肾结石疾病之间存在关联；然而，这些研究并没有对肥胖和高血压等重要的潜在混杂因素进行调整。据我们所知，没有发表的研究调查痛风和肾结石疾病之间的独立联系。方法：我们使用美国人口的全国概率样本来确定报告的痛风和肾结石病史之间的独立关联。结果：在20岁及以上的男性和女性中，5.6%（1000万）报告曾有肾结石排出，2.7%（510万）报告曾被医生诊断为痛风。此外，8.6%报告有两次或两次以上肾结石排出的人有痛风病史。相反，痛风患者既往肾结石患病率为13.9%。在年龄调整模型中，痛风与既往肾结石的优势比（OR）增加相关（OR, 1.97； 95%可信区间[CI]， 1.37至2.83）。在进一步调整性别、种族、体重指数和是否存在高血压后，痛风患者既往肾结石的OR降至1.49 （95% CI, 1.04 - 2.14）。结论：肾结石疾病和痛风之间存在独立的联系，强烈提示它们具有共同的潜在病理生理机制。查明这些机制可能导致改进针对这两种情况的预防战略。(C) 2002年由国家肾脏基金会，Inc。
Background: Gout, an inflammatory arthritis, reportedly afflicts more than 2 million men and women in the United States. Previous reports have suggested an association between gout and kidney stone disease; however, these studies did not adjust for such important potential confounders as obesity and the presence of hypertension. To our knowledge, no published study has examined the independent association between gout and kidney stone disease. Methods: We used a national probability sample of the US population to determine the independent association between reported gout and history of kidney stone disease. Results: Among men and women 20 years and older, 5.6% (10 million) reported the previous passage of a kidney stone and 2.7% (5.1 million) reported a diagnosis of gout by a physician. Moreover, 8.6% of individuals who reported the passage of a kidney stone on two or more occasions had a history of gout. Conversely, the prevalence of previous kidney stones in subjects with reported gout was 13.9%. In the age-adjusted model, gout was associated with an increased odds ratio (OR) for previous kidney stones (OR, 1.97; 95% confidence interval [CI], 1.37 to 2.83). After further adjustment for sex, race, body mass index, and presence of hypertension, the OR for previous kidney stones in individuals with gout decreased to 1.49 (95% CI, 1.04 to 2.14). Conclusion: Showing an independent association between kidney stone disease and gout strongly suggests that they share common underlying pathophysiological mechanisms. Identification of these mechanisms may lead to improved preventive strategies for both conditions. (C) 2002 by the National Kidney Foundation, Inc.