The Association of Increasing Body Mass Index and Kidney Stone Disease
The Association of Increasing Body Mass Index and Kidney Stone Disease
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DOI：
10.1016/j.juro.2009.09.085
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发表时间：
2010-02-01
影响因子：
6.6
通讯作者：
Matlaga, Brian R.
中科院分区：
文献类型：
--
作者：
Semins, Michelle J.;Shore, Andrew D.;Matlaga, Brian R.
目的：以往的流行病学研究报道，肥胖是肾结石疾病的危险因素。然而，肥胖程度的增加对结石形成的影响还有待确定。为了解决这个问题，我们研究了不断增加的体重指数如何影响肾结石疾病的风险。材料和方法：我们评估了国家私人保险数据库中5年(2002年至2006年)的索赔，以确定被诊断为肾结石或接受治疗的受试者。从95598名患者的数据集中，受试者通过针对肾结石疾病的ICD-9或CPT代码进行识别。结果：3257例结石患者中，男性占42.9%，女性占57.1%。肥胖(身体质量指数大于30公斤/米(2))与被诊断为肾结石的可能性显著增加相关。然而，当肥胖患者按体重指数分层时，诊断为肾结石的可能性没有显著差异，这表明一旦体重指数增加到30公斤/米以上，风险就会稳定下来。只有体重指数在30到45 kg/m(2)之间的男性和女性相对于体重指数小于25 kg/m(2)的男性和女性(p<；0.001)，体重指数与结石取石手术的相关性是显著的。结论：肥胖的体重指数与肾结石疾病的风险增加有关。然而，在病态肥胖人群中，这种风险的大小似乎是稳定的。一旦体重指数大于30公斤/米(2)，进一步增加似乎不会显著增加结石疾病的风险。
Purpose: Previous epidemiological works have reported that obesity is a risk factor for kidney stone disease. However, the effect of increasing degrees of obesity on stone formation has yet to be defined. To address this question we examined how an increasing body mass index affects the risk of kidney stone disease.Materials and Methods: We evaluated claims from a 5-year period (2002 to 2006) in a national private insurance database to identify subjects diagnosed with or treated for kidney stones. From a data set of 95,598 patients, subjects were identified by ICD-9 or CPT codes specific to kidney stone disease. Descriptive analyses were performed and odds ratios were calculated.Results: Gender distribution of the 3,257 stone formers was 42.9% male and 57.1% female. Obesity (body mass index greater than 30 kg/m(2)) was associated with a significantly greater likelihood of being diagnosed with a kidney stone. However, when obese patients were stratified by body mass index there were no significant differences in the likelihood of a kidney stone diagnosis, suggesting a stabilization of risk once body mass index increased above 30 kg/m(2). The association of body mass index and a stone removal procedure was significant only for men and women with a body mass index between 30 and 45 kg/m(2) relative to a body mass index less than 25 kg/m(2) (p < 0.001).Conclusions: An obese body mass index is associated with an increased risk of kidney stone disease. However, the magnitude of this risk appears to be stable in the morbidly obese population. Once body mass index is greater than 30 kg/m(2), further increases do not appear to significantly increase the risk of stone disease.