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Yang S, Ling J, Zhang S, Li Y, Yang G. Metabolic dysfunction, rather than obesity, is a risk factor for chronic kidney disease in Chinese population. Aging Male 2024; 27:2335158. [PMID: 38600669 DOI: 10.1080/13685538.2024.2335158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 03/21/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND Metabolic dysfunction and obesity are closely related to chronic kidney disease (CKD). However, studies on the relationship between various metabolic syndrome-body mass index (MetS-BMI) phenotypes and the risk of CKD in the Chinese population have not yet been explored. MATERIALS AND METHODS Data from the China Health and Retirement Longitudinal Study (CHARLS) 2015 were analyzed in this study. This study enrolled 12,054 participants. Participants were divided into six distinct groups according to their MetS-BMI status. Across the different MetS-BMI groups, the odd ratios (ORs) for CKD were determined using multivariable logistic regression models. RESULTS The prevalence of CKD was higher in metabolically unhealthy groups than in the corresponding healthy groups. Moreover, the fully adjusted model showed that all metabolically unhealthy individuals had an increased risk of developing CKD compared to the metabolically healthy normal weight group (OR = 1.62, p = 0.002 for the metabolically unhealthy normal weight group; OR = 1.55, p < 0.001 for the metabolically unhealthy overweight group; and OR = 1.77, p < 0.001 for the metabolically unhealthy obesity group. CONCLUSIONS This study is the first to evaluate the relationship between the MetS-BMI phenotype and renal prognosis in the Chinese population. Individuals with normal weights are at different risk of developing CKD depending on their different metabolic phenotypes.
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Affiliation(s)
- Shan Yang
- Department of Endocrinology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, PR China
| | - Jiaxiu Ling
- Department of Endocrinology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, PR China
| | - Siliang Zhang
- Department of Endocrinology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, PR China
| | - Yang Li
- Department of Endocrinology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, PR China
| | - Gangyi Yang
- Department of Endocrinology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, PR China
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Dassanayake SN, Lafont T, Somani BK. Association and risk of metabolic syndrome and kidney stone disease: outcomes from a systematic review and meta-analysis. Curr Opin Urol 2024:00042307-990000000-00189. [PMID: 39252614 DOI: 10.1097/mou.0000000000001227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/11/2024]
Abstract
PURPOSE OF REVIEW Metabolic syndrome (MetS) has emerged as a potential contributor to the development of kidney stone disease (KSD). This study aims to conduct a systematic review of the literature, and meta-analysis of the association between MetS and KSD. RECENT FINDINGS Systematic review revealed Fifteen articles (433 201 patients) were eligible for analysis. Meta-analysis of 11 studies identified a statistically significant association between MetS and KSD with unadjusted odds ratio of 2.02 [95% confidence interval (CI) 1.96-2.08, P < 0.001], and pooled adjusted odds ratio of 1.22 [95% CI 1.09-1.37, P < 0.001]. Of the different MetS traits, hypertension and impaired glucose tolerance were the most significantly associated with KSD. SUMMARY This study confirms a significant association between MetS and KSD. Despite variations in MetS definitions across different studies analysed, consistent associations were observed across studies. This may have clinical implications in that guidelines do not currently recommend routine MetS screening in KSD patients.
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Affiliation(s)
| | - Tanguy Lafont
- NIHR Academic Clinical Fellow in Renal Medicine, King's College London
| | - Bhaskar K Somani
- Professor of Urology, University Hospital Southampton NHS Trust, UK
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Zheng X, Wu Y, Huang L, Xiong J. Trajectories of body mass index and incident kidney stone disease: a prospective cohort study in Chinese young adults. Urolithiasis 2024; 52:118. [PMID: 39167208 DOI: 10.1007/s00240-024-01617-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Accepted: 08/12/2024] [Indexed: 08/23/2024]
Abstract
The present study aims to explore the potential changing trajectory patterns of body mass index (BMI) for Chinese young adults and identify the relationship of BMI trajectory patterns with kidney stone disease (KSD) incidence. Latent class growth analysis was used to identify distinct trajectories of BMI during young adulthood. Cox proportion hazard models were conducted to explore the association between the BMI trajectory group memberships and incident KSD. Subgroup and sensitivity analyses were undertaken to test the robustness of the findings. In total, 2,966 young adults who attended at least three annual check-ups from 2014 to 2021 without KSD at baseline were enrolled in the cohort analysis. Three district BMI trajectories were identified for young adults, labeled as low-stable in normal BMI (28.5%), medium-rising to high BMI (67.4%), and rapid-rising to high BMI (4.1%). Compared with the low-stable in normal BMI group, Hazard ratios (HRs) of the rapid-rising and medium-rising to high BMI groups were 3.19 (95% CI: 1.54-6.63) and 1.78 (95% CI: 1.08-2.92) after adjusting the covariates. The cumulative incidence curves likewise illustrated that young adults in the rapid-rising to high BMI group had the highest risk of developing KSD compared to the other two groups. The rapid BMI growth trajectories during young adulthood were identified to be independently associated with a higher risk of KSD. The findings supplied novel insights that monitoring the BMI changing pattern may be favorable to early intervention of KSD during young adulthood.
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Affiliation(s)
- Xujuan Zheng
- Medical School, Shenzhen University, 1066 Xueyuan Road, Shenzhen, Guangdong Province, 518060, China
| | - Yanxia Wu
- Health Management Centre, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong Province, 518020, China
| | - Lingling Huang
- Medical School, Shenzhen University, 1066 Xueyuan Road, Shenzhen, Guangdong Province, 518060, China
| | - Juan Xiong
- Medical School, Shenzhen University, 1066 Xueyuan Road, Shenzhen, Guangdong Province, 518060, China.
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Li Y, Di X, Liu M, Wei J, Li T, Liao B. Association between daily sitting time and kidney stones based on the National Health and Nutrition Examination Survey (NHANES) 2007-2016: a cross-sectional study. Int J Surg 2024; 110:4624-4632. [PMID: 38768465 PMCID: PMC11325893 DOI: 10.1097/js9.0000000000001560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 04/23/2024] [Indexed: 05/22/2024]
Abstract
BACKGROUND Kidney stones are among the most common urological conditions affecting ~9% of the world population. Although some unhealthy diets and unhealthy lifestyles are reportedly risk factors for kidney stone, the association between daily sitting time and kidney stone has not been explored. MATERIALS AND METHODS This large-scale, cross-sectional study was conducted using data from the National Health and Nutrition Examination Survey (NHANES) database 2007-2016. Kidney stone history and daily sitting time were retrieved from the questionnaire and 24 hour (h) recall interviews. Logistic regression and subgroup analysis were conducted to investigate the association. The analysis was further stratified by vigorous recreational activity. RESULTS A total of 19 188 participants aged ≥20 years with complete information were included in this study. The overall prevalence of kidney stone was 9.6%. Among participants without vigorous recreational activity, a trend towards an increasing prevalence of kidney stone was observed with increased daily sitting time. However, the trend was not observed in individuals who participated in vigorous recreational activity, as they experienced a decreased risk of kidney stone despite having a daily sitting time of 6-8 h (crude model OR=0.659, 95% CI: 0.457-0.950, P =0.028), indicating that vigorous recreational activity may partially attenuate the detrimental effect of prolonged sitting time. CONCLUSION Our study revealed an increasing trend of prevalence of kidney stone with increased daily sitting time among the population not performing vigorous recreational activity despite the difference was nonsignificant. Vigorous recreational activity may modify the association between daily sitting time and kidney stone. More prospective cohort studies are warranted to further examine this association.
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Affiliation(s)
- Ya Li
- Department of Urology and Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
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Cheng Y, Zheng H, Yin H, Yin D, Wang H, Wang Y, Tang Q, Gu S. Changes in metabolic overweight phenotypes over time and risk of nephrolithiasis: a cohort study. BMC Public Health 2024; 24:1898. [PMID: 39014388 PMCID: PMC11251252 DOI: 10.1186/s12889-024-19229-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 06/21/2024] [Indexed: 07/18/2024] Open
Abstract
BACKGROUND Overweight/obesity is considered an independent risk factor for nephrolithiasis, but little is known about its effect on nephrolithiasis according to metabolic health status. OBJECTIVES We aimed to investigate the association between various metabolic overweight phenotypes and the occurrence of nephrolithiasis. It also explores whether changes in these phenotypes over time influence the risk of nephrolithiasis. MATERIALS AND METHODS A total of 10,315 participants free of nephrolithiasis who underwent an annual health checkup from 2017 to 2022 were included in our prospective cohort study. They were categorized into four groups according to the presence of overweight and metabolic abnormalities (MA). The primary endpoint was the occurrence of renal stones. Multivariable Cox analysis was conducted to elucidate the relationship between metabolic overweight phenotypes and incident nephrolithiasis. RESULTS During a median follow-up duration of 4.02 years, nephrolithiasis occurred in 1,468 (14.23%) participants. In the full cohort, we observed that the 5-year cumulative incidences of nephrolithiasis were highest in the metabolically healthy overweight (MHO) and metabolically abnormal overweight (MAO) groups. The hazard ratios (HRs) for nephrolithiasis, relative to metabolically healthy normal weight (MHNW), ranged from 1.19 (95% CI:1.03-1.37; MHO) to 1.32 (95% CI:1.15-1.51; MAO). Furthermore, individuals with persistent MHO throughout follow-up were at a 1.42-fold increased risk of nephrolithiasis (P < 0.001), and 32.17% of individuals experienced changes in phenotype during follow-up. Among MAO subjects, those who transitioned to MHO and MHNW had a 26% and 45% lower risk of incident nephrolithiasis, respectively, compared to those who persisted in the MAO phenotype. CONCLUSION Individuals in the MHO and MAO groups exhibit an elevated risk of incident nephrolithiasis in this prospective cohort study. A significant proportion of nephrolithiasis cases may be potentially preventable through the appropriate management of metabolic risk factors for MAO subjects.
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Affiliation(s)
- Yang Cheng
- Center for Health Management, Jiangsu Province Geriatric Hospital, 2 Yi-He Road, Nanjing, 210009, China
| | - Hui Zheng
- Center for Health Management, Jiangsu Province Geriatric Hospital, 2 Yi-He Road, Nanjing, 210009, China
| | - Hongli Yin
- Center for Health Management, Jiangsu Province Geriatric Hospital, 2 Yi-He Road, Nanjing, 210009, China
| | - Donghua Yin
- Center for Health Management, Jiangsu Province Geriatric Hospital, 2 Yi-He Road, Nanjing, 210009, China
| | - Hui Wang
- Center for Health Management, Jiangsu Province Geriatric Hospital, 2 Yi-He Road, Nanjing, 210009, China
| | - Ying Wang
- Center for Health Management, Jiangsu Province Geriatric Hospital, 2 Yi-He Road, Nanjing, 210009, China.
| | - Qiang Tang
- School of Sports and Health, Nanjing Sport Institute, 8 Ling-Gu Temple Road, Nanjing, 210014, China.
- Jiangsu Collaborative Innovation Center for Sport and Health Project, Nanjing, China.
| | - Shouyong Gu
- Institute of Geriatric Medicine, Jiangsu Province Geriatric Hospital, 65 Jiang-Su Road, Nanjing, 210009, China.
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Yan J, Li S. Evaluating the lipid accumulation product index as a predictor for kidney stone prevalence: insights from NHANES 2007-2018. Int Urol Nephrol 2024:10.1007/s11255-024-04112-7. [PMID: 38869668 DOI: 10.1007/s11255-024-04112-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 06/05/2024] [Indexed: 06/14/2024]
Abstract
PURPOSE This study aimed to explore the relationship between the lipid accumulation product (LAP) index and kidney stone prevalence, utilizing data from the National Health and Nutrition Examination Survey (NHANES) spanning 2007 to 2018. METHODS An observational study was executed employing the NHANES dataset from 2007 to 2018. Analytical methods encompassed multivariate logistic regression, restricted cubic splines (RCS), subgroup analysis, and interaction tests. Predictions were made using the receiver operating characteristic (ROC) curve and the area under the curve (AUC) values. RESULTS The analysis included 9744 adults aged 20 years and older. Multivariate logistic regression identified a significant positive association between log2-transformed LAP (treated as a continuous variable) and kidney stone risk across all models, with odds ratios (ORs) exceeding 1 and p values less than 0.001. Categorically, ORs escalated with increasing LAP levels, indicating a dose-response relationship. The RCS analysis confirmed a linear positive correlation between log2-transformed LAP and kidney stone risk. Subgroup analyses revealed that the log2-transformed LAP-kidney stones relationship was consistent, unaffected by stratification across the examined variables. In addition, LAP index (AUC = 0.600) proved to be a more effective predictor of kidney stones compared to body mass index (AUC = 0.584). CONCLUSION Elevated LAP levels are positively correlated with a higher incidence of kidney stones, signifying its potential as a risk marker for this condition. Future research should investigate the mechanisms underlying this relationship. LAP can be used as a new anthropometric index to predict kidney stones, and its predictive ability is stronger than body mass index.
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Affiliation(s)
- Ji Yan
- The Second School of Medicine, Wenzhou Medical University, Wenzhou, China
| | - Sen Li
- School of Basic Medical Sciences, Wenzhou Medical University, Wenzhou, China.
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Liang D, Liu C, Yang M. The association of visceral adiposity index with the risk of kidney stone and kidney stone recurrence. BMC Nephrol 2023; 24:368. [PMID: 38087224 PMCID: PMC10717979 DOI: 10.1186/s12882-023-03421-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 12/02/2023] [Indexed: 12/18/2023] Open
Abstract
AIM Our aim in this study was primarily to assess the relationship between visceral adiposity index (VAI) and the risk of kidney stones and kidney stone recurrence in US adults. METHODS We used data from the National Health and Nutrition Examination Survey (NHANES) 2007-2014 for our analysis. VAI was calculated from waist circumference (WC), body mass index (BMI), triglycerides (TG), and high-density lipoprotein-cholesterol (HDL-C). Kidney stones and recurrence of kidney stones were obtained from questionnaire interview data. We used multivariate logistic regression analysis to explore the correlation between VAI and the risk of kidney stone and kidney stone recurrence. In addition, we performed subgroup analysis, interaction tests, and restricted cubic spline (RCS) analysis. RESULTS A total of 9886 participants were included in this study, with a prevalence of 9.24% for kidney stones and 2.97% for recurrence of kidney stones. The prevalence of kidney stones and kidney stone recurrence increased with higher quartiles of VAI. We observed a significantly positive correlation between VAI and the risk of kidney stone and kidney stone recurrence. Participants with the highest VAI quartiles had a 48% (OR: 1.48, 95%CI: 1.08-2.02) and 52% (OR: 1.52, 95%CI: 0.86-2.71) increased risk of kidney stones and kidney stone recurrence, respectively, compared to participants with the lowest VAI quartiles. Subgroup analysis and interaction tests demonstrated this positive association independent of different subgroup factors. CONCLUSION Visceral fat accumulation may be associated with an increased risk of kidney stones and kidney stone recurrence.
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Affiliation(s)
- Dan Liang
- Department of Endocrine, People's Hospital of Chongqing Liang Jiang New Area, Chongqing, China
- The West China College of Medicine, Sichuan University, Chengdu, China
| | - Chang Liu
- School of Medicine, Nankai University, Tianjin, China
| | - Mei Yang
- Department of Endocrine, People's Hospital of Chongqing Liang Jiang New Area, Chongqing, China.
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