The association between gout and nephrolithiasis in men: The Health Professionals' Follow-Up Study
The association between gout and nephrolithiasis in men: The Health Professionals' Follow-Up Study
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DOI：
10.1046/j.1523-1755.2003.t01-2-00171.x
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发表时间：
2003-09-01
影响因子：
19.6
通讯作者：
Curhan, GC
中科院分区：
文献类型：
--
作者：
Kramer, HJ;Choi, HK;Curhan, GC
在美国，大约有1000万成年人经历过肾结石的通过，多达500万人被医生诊断患有痛风。以前的报告表明，痛风会增加肾结石的风险，但没有前瞻性数据。我们使用了来自51，529名男性医疗保健专业人员的数据，以检查痛风和肾结石疾病之间的独立关联。在对1986年基线调查问卷报告的痛风和肾结石疾病的横断面分析中，有痛风史的男性肾结石疾病的患病率几乎是无痛风史男性的两倍（15%对8%）。在调整年龄和体重指数（BMI）后，痛风史与肾结石疾病仍显著相关（OR 1.88; 95%CI 1.68 - 2.11）。然后，我们前瞻性地研究了在排除基线问卷中报告有肾结石病或痛风病史的男性后，确诊或未确诊痛风的男性发生肾结石的风险。确诊痛风增加了肾结石发生的多变量相对风险（RR 2.12; 95%CI 1.22 - 3.68）。相反，肾结石病史与痛风风险增加无关（RR 1.05; 95%CI 0.54 - 2.07）。总之，痛风史独立地增加男性肾结石的发病风险。除了其他风险因素（如肾结石家族史）外，医生还应向痛风受试者提供饮食咨询，如增加液体摄入量和减少盐摄入量，以降低结石形成的可能性。
Approximately 10 million adults in the United States have experienced the passage of a kidney stone, and up to 5 million have been diagnosed with gout by a physician. Previous reports have suggested that gout increases the risk for the development of kidney stones, but there are no prospective data. We used data from a cohort of 51,529 male health care professionals to examine the independent association between gout and kidney stone disease. In a cross-sectional analysis of gout and kidney stone disease reported on the 1986 baseline questionnaire, the prevalence of kidney stone disease was almost twofold higher in men with history of gout compared to those without (15% vs. 8%). After adjusting for age and body mass index (BMI), a history of gout remained significantly associated with kidney stone disease (OR 1.88; 95% CI 1.68 to 2.11). We then prospectively examined the risk of incident kidney stones in men with and without a confirmed diagnosis of gout after excluding men who reported a history of kidney stone disease or gout on the baseline questionnaire. A confirmed diagnosis of gout increased the multivariate relative risk of incident kidney stones (RR 2.12; 95% CI 1.22 to 3.68). In contrast, a history of kidney stone disease was not associated with increased risk of gout (RR 1.05; 95% CI 0.54 to 2.07). In conclusion, a history of gout independently increases the risk for incident kidney stones in men. Physicians should provide dietary counseling, such as increasing fluid intake and decreasing salt consumption, to subjects with gout in addition to other risk factors, such as family history of kidney stones, in order to decrease the likelihood of stone formation.