Caffeine intake and the risk of kidney stones
Caffeine intake and the risk of kidney stones
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DOI：
10.3945/ajcn.114.089987
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发表时间：
2014-12-01
影响因子：
7.1
通讯作者：
Curhan, Gary C.
中科院分区：
文献类型：
--
作者：
Ferraro, Pietro Manuel;Taylor, Eric N.;Curhan, Gary C.
背景：虽然咖啡因摄入可能会增加尿钙排泄，但含咖啡因饮料与肾结石的风险较低有关。目的：我们试图在3个大型前瞻性队列中确定咖啡因摄入量与肾结石发生风险之间的关系。设计：我们前瞻性地分析了3项正在进行的大型队列研究，即卫生专业人员随访研究（HPFS）和护士健康研究（NHS） I和II中咖啡因摄入量与肾结石发病率之间的关系。通过有效的问卷收集了咖啡因摄入量和肾结石发病率的信息。结果：共纳入217,883名受试者；在中位随访80年期间，发生了4982例事件。在对年龄、体重指数、液体摄入量和其他因素进行多因素调整后，咖啡因摄入量最高的五分位数的参与者在HPFS队列中患结石的风险降低26% (95% CI: 12%, 38%)，在NHS I队列中风险降低29% (95% CI: 15%, 41%)，在NHS II队列中风险降低31% (95% CI: 18%, 42%)（所有队列的p趋势< 0.001）。在HPFS队列中，低摄入或不摄入含咖啡因咖啡的参与者亚组中，这种关联仍然显著。在6033名有24小时尿液数据的参与者中，咖啡因的摄入与较高的尿量、钙和钾以及较低的尿草酸、草酸钙和尿酸过饱和有关。结论：咖啡因摄入与较低的肾结石发生率独立相关。
Background: Although caffeine intake may increase urine calcium excretion, caffeine-containing beverages have been associated with a lower risk of nephrolithiasis.Objective: We sought to determine the association between caffeine intake and the risk of incident kidney stones in 3 large prospective cohorts.Design: We prospectively analyzed the association between intake of caffeine and incidence of kidney stones in 3 large ongoing cohort studies, the Health Professionals Follow-Up Study (HPFS) and the Nurses' Health Studies (NHS) I and II. Information on the consumption of caffeine and the incidence of kidney stones was collected by validated questionnaires.Results: The analysis included 217,883 participants; over a median follow-up of >8 y, 4982 incident cases occurred. After multivariate adjustment for age, BMI, fluid intake, and other factors, participants in the highest quintile of caffeine intake had a 26% (95% CI: 12%, 38%) lower risk of developing stones in the HPFS cohort, a 29% lower risk (95% Cl: 15%, 41%) in the NHS I cohort, and a 31% lower risk (95% CI: 18%, 42%) in the NHS II cohort (P-trend < 0.001 for all cohorts). The association remained significant in the subgroup of participants with a low or no intake of caffeinated coffee in the HPFS cohort. Among 6033 participants with 24-h urine data, the intake of caffeine was associated with higher urine volume, calcium, and potassium and with lower urine oxalate and supersaturation for calcium oxalate and uric acid.Conclusion: Caffeine intake is independently associated with a lower risk of incident kidney stones.