Influence of body size on urinary stone composition in men and women
Influence of body size on urinary stone composition in men and women
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DOI：
10.1007/s00240-006-0042-8
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发表时间：
2006-06-01
影响因子：
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通讯作者：
Jungers, P
中科院分区：
文献类型：
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作者：
Daudon, M;Lacour, B;Jungers, P
较大的体型已被证明与尿中成石溶质的排泄增加有关，并且据报道超重患者患肾结石的风险增加。然而，这些对象中产生的结石类型尚未确定。基于大量的结石，我们检查了身体尺寸和结石成分之间的关系，以评估哪种类型的结石主要受超重的青睐。在我们实验室提交的 18,845 例连续结石中，有 2,100 例来自有身高和体重记录的成年人。排除糖尿病患者的结石以及鸟粪石和胱氨酸结石，研究材料由 1,931 块钙或尿酸结石组成。所有结石均通过红外光谱分析并根据其主要成分进行分类。体重指数 (BMI) 值分为正常 BMI (< 25 kg/m(2))、超重 (BMI 25-29.9) 或肥胖 (BMI >= 30)。总体而言，27.1% 的男性结石患者和 19.6% 的女性结石患者超重，8.4% 和 13.5% 的女性肥胖。在男性中，超重和肥胖组的钙结石比例低于BMI正常组，而尿酸结石比例随着BMI的增加而逐渐增加，从BMI正常组的7.1%增加到肥胖组的28.7%（P < 0.0001）。女性的情况也是如此，尿酸结石的比例从正常BMI的6.1%上升到肥胖患者的17.1%（P=0.003）。此外，无论性别，尿酸结石的比例均随着年龄的增长而显着上升（P < 0.0001）。年龄<60岁的尿酸结石形成者的平均BMI值显着高于所有其他组，而年龄>=60岁的组与其他组没有差异。逐步回归分析将体重指数和年龄确定为与尿酸结石风险相关的显着独立协变量。我们的数据提供证据表明，60 岁以下患者中，超重与较高比例的尿酸结石有关，而超过此限制，年龄增长是主要危险因素。
A larger body size has been shown to be associated with increased excretion of urinary lithogenic solutes, and an increased risk of nephrolithiasis has been reported in overweight patients. However, the type of stones produced in these subjects has not been ascertained. Based on a large series of calculi, we examined the relationship between body size and the composition of stones, in order to assess which type of stone is predominantly favoured by overweight. Among 18,845 consecutive calculi referred to our laboratory, 2,100 came from adults with recorded body height and weight. Excluding calculi from patients with diabetes mellitus, as well as struvite and cystine stones, the study material consisted of 1,931 calcium or uric acid calculi. All calculi were analysed by infrared spectroscopy and categorized according to their main component. Body mass index (BMI) values were stratified as normal BMI (< 25 kg/m(2)), overweight (BMI 25-29.9) or obese (BMI >= 30). Overall, 27.1% of male and 19.6% of female stone formers were overweight, and 8.4 and 13.5% were obese, respectively. In males, the proportion of calcium stones was lower in overweight and obese groups than in normal BMI group, whereas the proportion of uric acid stones gradually increased with BMI, from 7.1% in normal BMI to 28.7% in obese subjects (P < 0.0001). The same was true in females, with a proportion of uric acid stones rising from 6.1% in normal BMI to 17.1% in obese patients (P=0.003). In addition, the proportion of uric acid stones markedly rose with age in both genders (P < 0.0001). The average BMI value was significantly higher in uric acid stone formers aged < 60 years than in all other groups, whereas it did not differ from other groups in those aged >= 60 years. Stepwise regression analysis identified BMI and age as significant, independent covariates associated with the risk of uric acid stones. Our data provide evidence that overweight is associated with a high proportion of uric acid stones in patients less than 60 years of age, whereas beyond this limit, advancing age is the main risk factor.