The Effect of Disease Severity on 24-Hour Urine Parameters in Kidney Stone Patients With Type 2 Diabetes
The Effect of Disease Severity on 24-Hour Urine Parameters in Kidney Stone Patients With Type 2 Diabetes
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DOI：
10.1016/j.urology.2015.10.013
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发表时间：
2016-01-01
期刊：
影响因子：
2.1
通讯作者：
Stern, Joshua M.
中科院分区：
文献类型：
--
作者：
Fram, Ethan B.;Moazami, Saman;Stern, Joshua M.
目的 为了表征与糖尿病严重程度增加相关的尿液成分变化，我们分析了大部分少数人群中相对于糖化血红蛋白 (HbA1c) 的尿液成分和治疗策略。 方法 本研究纳入了 2001 年至 2013 年间在一家三级机构接受肾结石治疗并采集了 24 小时尿液的患者。患有 1 型糖尿病或服用噻嗪类利尿剂或碱化剂的患者被排除在外。使用多元回归在 IBM SPSS Statistics 版本 20 中进行分析，并使用 Kruskal-Wallis 检验。 结果 本研究纳入了 955 名患者，其中 268 名 (28%) 患有 2 型糖尿病，其中 53 名 (19.8%) 使用胰岛素。与对照组相比，糖尿病患者的尿液pH值、钙和磷酸盐较低，但糖尿病组之间没有发现显着差异。多变量分析发现，HbA1c 与柠檬酸盐 (P = .008)、肌酐 (P = .037)、尿量 (P = .044) 呈正相关，并有与尿钙呈正相关的趋势 (P = .064)。胰岛素使用与泌尿参数没有显着关系，但与钙呈反比关系 (P = .051)。 pH 值并不是任何尿液成分的显着预测因子。 结论 在不同种族的内城患者群体中，使用胰岛素的 2 型糖尿病患者与口服降糖药的患者相比，尿液参数没有显着差异。通过 HbA1c 水平测量的血糖控制恶化预示着尿柠檬酸盐和尿量的增加。 (C) 2015 爱思唯尔公司
OBJECTIVETo characterize the changes in urine composition associated with increasing severity of diabetes, we analyzed urine composition relative to glycated hemoglobin (HbA1c) and treatment strategy in a largely minority population.METHODSPatients treated for kidney stones between 2001 and 2013 at a single tertiary institution and had 24-hour urine collections were included in the study. Patients with type 1 diabetes or taking either thiazide diuretics or alkalinizing agents were excluded. Analysis was performed in IBM SPSS Statistics version 20 using multivariate regression, and Kruskal-Wallis testing was used.RESULTSNine hundred fifty-five patients were included in this study-268 (28%) with type 2 diabetes mellitus, of whom 53 (19.8%) used insulin. Patients with diabetes had lower urine pH, calcium, and phosphate when compared with the control group, but no significant differences were found between the diabetes groups. Multivariate analysis found that HbA1c had a positive correlation with citrate (P = .008), creatinine (P = .037), urine volume (P = .044), and a trend toward a positive association with urinary calcium calcium (P = .064). Insulin use did not have a significant relationship with urinary parameters but trended toward an inverse relationship with calcium (P = .051). pH was not a significant predictor of any urine constituent.CONCLUSIONIn an ethnically diverse inner city patient population, patients with diabetes mellitus type 2 who use insulin have no significant differences in urine parameters when compared with those on oral hypoglycemics. Worsening glucose control as measured by HbA1c levels predicts increased urine citrate and volume. (C) 2015 Elsevier Inc.