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Yao L, Yang P. Relationship between remnant cholesterol and risk of kidney stones in U.S. Adults: a 2007-2016 NHANES analysis. Ann Med 2024; 56:2319749. [PMID: 38733306 PMCID: PMC11089921 DOI: 10.1080/07853890.2024.2319749] [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: 02/10/2023] [Accepted: 02/10/2024] [Indexed: 05/13/2024] Open
Abstract
PURPOSE Remnant cholesterol (RC) is the cholesterol content of triglyceride-rich lipoproteins. This study aimed to investigate the association between RC levels and kidney stones in U.S. adults. METHODS Data were obtained from the 2007 to 2016 National Health and Nutrition Examination Survey (NHANES). A total of 10,551 participants with complete data were included and analyzed in this study. Univariate and multivariate logistic regression analysis, restricted cubic spline function, subgroup analysis and mediation analysis were preformed to estimate the independent relationship between RC levels and kidney stones. RESULTS Participants with stone formation had higher levels of RC than those with without stone formation (25.78 ± 13.83 vs 23.27 ± 13.04, p< 0.001). The results of logistic regression analysis and dose-response risk curves revealed a positive nonlinear association between RC levels and risk of kidney stones [univariate: adjusted odds ratio (aOR) =2.388, 95% CI: 1.797-3.173, p< 0.001; multivariate: aOR = 1.424, 95% CI: 1.050-1.929, p = 0.023]. Compared with the discordantly low RC group, the discordantly high RC group was associated with increased risk of kidney stones (aOR = 1.185, 95% CI: 1.013-1.386, p= 0.034). Similar results were demonstrated according to the discordance of different clinical cut points. And metabolic syndrome parameters and vitamin D levels parallelly mediated the association between RC and kidney stone risk. CONCLUSIONS Higher RC levels were independently associated with an increased risk of kidney stone incidence.
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Affiliation(s)
- Lei Yao
- Department of Urology, The People’s Hospital of Yingshang, Yingshang, Anhui, China
| | - Peigang Yang
- Department of Urology, The People’s Hospital of Yingshang, Yingshang, Anhui, China
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Hong H, He Y, Gong Z, Feng J, Qu Y. The association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and kidney stones: a cross-sectional study. Lipids Health Dis 2024; 23:102. [PMID: 38615008 PMCID: PMC11015599 DOI: 10.1186/s12944-024-02089-x] [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: 02/10/2024] [Accepted: 03/24/2024] [Indexed: 04/15/2024] Open
Abstract
BACKGROUND The relationship between the NHHR and kidney stone risk remains unknown. The purpose of this study was to evaluate the association between adult NHHR and kidney stone occurrence in USA. METHODS This study used a variety of statistical techniques such as threshold effects, subgroup analysis, smooth curve fitting, multivariate logistic regression, and data from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2014. We aimed to clarify the relationship between the NHHR and kidney stone risk. RESULTS The average age of the 21,058 individuals in this research was 49.70 ± 17.64 years. The mean NHHR was 3.00 ± 1.47, and the overall prevalence of kidney stone occurrence was 9.05%. The prevalence within the quartile ranges (Q1-Q4) was 7.01%, 8.71%, 9.98%, and 10.49%, respectively. The overall average recurrence rate of kidney stones was 3.05%, demonstrating a significant increase with increasing NHHR (Q1: 1.92%, Q2: 2.92%, Q3: 3.35%, Q4: 4.00%, P < 0.01). The occurrence of kidney stones increased by 4% (95% CI: 1.00-1.08, P = 0.0373) and the chance of recurrence increased by 9% (95% CI: 1.03-1.14, P < 0.01) with each unit increase in NHHR. The interaction analysis results demonstrated that the relationship between the NHHR and the risk of kidney stones was not significantly impacted by the following factors: sex, body mass index, poverty income ratio, diabetes, or hypertension. Curve fitting and threshold effect analysis also demonstrated a non-linear association, with a breakpoint found at 3.17, between the NHHR and the risk of kidney stones. CONCLUSIONS In adults in the USA, there is a substantial correlation between elevated NHHR levels and a higher probability of kidney stones developing and recurring. Timely intervention and management of NHHR may effectively mitigate the occurrence and recurrence of kidney stones.
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Affiliation(s)
- Hujian Hong
- Department of Radiation Oncology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Cancer Hospital of Dalian University of Technology, No.44 Xiaoheyan Road, Dadong District, Shenyang, 110042, Liaoning, China
- School of Graduate, Dalian Medical University, Dalian, 116044, Liaoning, China
| | - Yijiang He
- Department of Radiation Oncology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Cancer Hospital of Dalian University of Technology, No.44 Xiaoheyan Road, Dadong District, Shenyang, 110042, Liaoning, China
| | - Zhiqiang Gong
- Department of Radiation Oncology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Cancer Hospital of Dalian University of Technology, No.44 Xiaoheyan Road, Dadong District, Shenyang, 110042, Liaoning, China
| | - Jilong Feng
- Department of Radiotherapy, Shenyang Fifth People's Hospital, No.188 Xingshun Street, Tiexi District, Shenyang, 110023, Liaoning, China
| | - Yanli Qu
- Department of Radiation Oncology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Cancer Hospital of Dalian University of Technology, No.44 Xiaoheyan Road, Dadong District, Shenyang, 110042, Liaoning, China.
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Gao M, Liu M, Zhu Z, Chen H. The association of dyslipidemia with kidney stone: result from the NHANES 2007-2020. Int Urol Nephrol 2024; 56:35-44. [PMID: 37725273 DOI: 10.1007/s11255-023-03784-x] [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: 08/17/2023] [Accepted: 09/01/2023] [Indexed: 09/21/2023]
Abstract
OBJECTIVE To examine the association between dyslipidemia and kidney stone disease (KSD). METHODS A cross-sectional study data from 2007 to 2020 National Health and Nutrition Examination Survey (NHANES) were analyzed. Multivariate logistic regression was conducted with serum lipid levels as the exposure and presence of KSD as the outcome, and included adjustment for confounders and subgroup analysis. RESULTS A total of 38,617 participants were enrolled and classified into two groups according to whether they ever had (n = 3689) or did not have (n = 34,928) KSD. After multivariate logistic regression models, compared to quartile 1 (Q1) of lipid profile, the participants in Q3 (OR 0.8380; 95 CI 0.7380, 0.9515, P < 0.01) and Q4 (OR 0.7373; 95 CI 0.6377, 0.8525, P < 0.01) of high-density lipoprotein cholesterol (HDL) had a significantly lower risk of KSD in adjusted model 3. Results remained stable after stratified by age, gender, and body mass index (BMI) in subgroup analysis. No association was observed between low-density lipoprotein cholesterol (LDL), total cholesterol (TC) and triglycerides (TG) levels, and KSD. CONCLUSIONS Low HDL was associated with a higher risk of kidney stones in the USA adult population.
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Affiliation(s)
- Meng Gao
- Department of Urology, Xiangya Hospital, Central South University, Changsha, 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Minghui Liu
- Department of Urology, Xiangya Hospital, Central South University, Changsha, 410008, China
| | - Zewu Zhu
- Department of Urology, Xiangya Hospital, Central South University, Changsha, 410008, China.
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.
| | - Hequn Chen
- Department of Urology, Xiangya Hospital, Central South University, Changsha, 410008, China.
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.
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Tan Z, Hong J, Sun A, Ding M, Shen J. Causal effects of circulating lipids and lipid-lowering drugs on the risk of urinary stones: a Mendelian randomization study. Front Endocrinol (Lausanne) 2023; 14:1301163. [PMID: 38107516 PMCID: PMC10722409 DOI: 10.3389/fendo.2023.1301163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 11/14/2023] [Indexed: 12/19/2023] Open
Abstract
Background Previous studies have yielded conflicting findings regarding the association between circulating lipids and lipid-lowering drugs with urinary stones, and the causal relationship between the two remains inconclusive. Objective This study aimed to assess the causal relationship between circulating lipids (Triglycerides [TG], low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], apolipoprotein A [APOA], apolipoprotein B [APOB] and Pure hypercholesterolaemia), lipid-lowering drugs (HMGCR [HMG-CoA reductase] inhibitors and PCSK9[Proprotein Convertase Subtilisin/Kexin Type 9] inhibitors) and the risk of urinary stones, using genetic data. Methods Genetic instrumental variables (GIVs) for circulating lipids and lipid-lowering drugs were obtained from the UK Biobank and existing literature. Outcome data were extracted from a genetic association database with 3,625 urinary stone cases and 459,308 controls. Two-sample MR analysis, employing the TwoSampleMR software package in R 4.2.3, was conducted to assess the associations between multiple exposures. The primary outcome was determined using the inverse variance weighted (IVW) method for the causal relationship between exposure and outcome, while additional methods such as MR-Egger, weighted median, simple mode, and weighted mode were utilized as supplementary analyses. Robustness of the Mendelian Randomization (MR) analysis results was assessed through leave-one-out analysis and funnel plots. Results The MR analysis revealed a significant association between elevated TG levels per 1 standard deviation and the occurrence of urinary stones (odds ratio [OR]: 1.002, 95% confidence interval [CI]: 1.000-1.003, P = 0.010). However, no significant association was observed between factors other than TG exposure and the risk of urinary stone occurrence across all methods(LDL-C: [OR], 1.001; 95% [CI], 1.000-1.003, P=0.132;HDL-C: [OR], 0.999; 95% [CI], 0.998-1.000, P=0.151;APOA:[OR] being 1.000 (95% [CI], 0.999-1.001, P=0.721;APOB: [OR] of 1.001 (95% [CI], 1.000-1.002, P=0.058;Pure hypercholesterolaemia: [OR] of 1.015 (95% [CI], 0.976-1.055, P=0.455) and lipid-lowering drugs (HMGCR inhibitors: [OR], 0.997; 95% [CI], 0.990-1.003, P=0.301 and PCSK9 inhibitors:[OR], 1.002; 95% [CI], 1.000-1.005, P=0.099). Conclusion Our findings provide conclusive evidence supporting a causal relationship between an increased risk of urinary stones and elevated serum TG levels. However, we did not find a significant association between urinary stone occurrence and the levels of LDL-C, HDL-C, APOA, APOB, Pure hypercholesterolaemia and lipid-lowering drugs.
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Affiliation(s)
- Zilong Tan
- Department of Urology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jing Hong
- School of Basic Medical Sciences, Peking University, Beijing, China
| | - Aochuan Sun
- Department of Geriatrics, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Mengdi Ding
- Department of Urology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jianwu Shen
- Department of Urology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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Cao C, Jin X, Ding Q, Zhu J, Yang D, Fan B. The altered composition of gut microbiota and biochemical features as well as dietary patterns in a southern Chinese population with recurrent renal calcium oxalate stones. Urolithiasis 2023; 51:95. [PMID: 37458823 DOI: 10.1007/s00240-023-01467-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 07/05/2023] [Indexed: 07/20/2023]
Abstract
The correlation among gut microbiota, biochemical features, and dietary patterns in recurrent stone formers has been inadequately investigated in the Chinese population. Forty-two patients with calcium oxalate stones (CaOxS group), including 34 recurrent stone formers (RS group), and 40 nonstone healthy subjects (NS group) from Changshu Hospital Affiliated with Soochow University, were prospectively recruited. Food frequency questionnaires were completed by participants, fasting vein blood was extracted, 24-h urine was collected for biochemical detection, and fecal samples were gathered for 16S ribosomal RNA (rRNA) gene sequencing. BMI; serum levels of triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), magnesium, and creatinine; and urine levels of magnesium in stone formers were significantly different from those of controls, and RS patients showed significantly low serum phosphate and high urine phosphate levels. Celery, bamboo shoots, and pickled food were the favored foods of local stone formers. Patients with recurrent stones had altered microbiota composition, with Escherichia, Fusobacterium, and Epulopiscium being the predominant pathogenic genera. The gut microbiota in RS patients had stronger functions in fatty acid and amino acid degradation but weaker functions in their biosynthesis. The pathogenic genera were positively correlated with BMI; serum levels of TGs and creatinine; urine levels of calcium, phosphate, and uric acid (UA); and celery, bamboo shoots, and pickled food intake. The abundance of Escherichia and Fusobacterium and the levels of serum magnesium and creatinine were the most relevant factors associated with stone recurrence and could be validated as biomarkers of recurrence. Our research provides a novel prevention strategy for the recurrence of renal calcium oxalate stones in the Han Chinese population of southern China.
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Affiliation(s)
- Cheng Cao
- Department of Urology, The Changshu Hospital Affiliated to Soochow University, Changshu, China
| | - Xiaohua Jin
- Department of Urology, The Changshu Hospital Affiliated to Soochow University, Changshu, China
| | - Qi Ding
- Department of Urology, The Changshu Hospital Affiliated to Soochow University, Changshu, China
| | - Jin Zhu
- Department of Urology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Dongrong Yang
- Department of Urology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Bo Fan
- Department of Urology, The Changshu Hospital Affiliated to Soochow University, Changshu, China.
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Zhu S, Fan Y, Hu X, Shao M. Insights into risk factors for urolithiasis: a mendelian randomization study. BMC Urol 2023; 23:76. [PMID: 37118729 PMCID: PMC10148447 DOI: 10.1186/s12894-023-01243-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 04/12/2023] [Indexed: 04/30/2023] Open
Abstract
BACKGROUND Risk factors for urolithiasis have not been identified. Here, we aimed to identify potentially causal risk factors driving the risk of urolithiasis. METHODS Two sets of instrumental variables were used for analysis, derived from publicly available databases. Summary-level statistical data for urolithiasis were obtained from the MRC-IEU Consortium and UK biobank (Neale Lab). Mendelian randomization (MR) was conducted to identify causal risk of urolithiasis. Finally, the results of the two databases were combined and a meta-analysis was performed. RESULTS In the MRC-IEU consortium, the odds of urolithiasis increased per 1-SD increase of body mass index (BMI) (OR = 1.0016, 95% CI:1.0004-1.0029, p = 0.010), triglycerides (OR = 1.0016, 95% CI:1.0003-1.0029, p = 0.017), adiponectin (OR = 1.0027, 95% CI:1.0003-1.0050, p = 0.024), and body fat percentage (OR = 1.008, 95% CI:1.0001-1.0161, p = 0.047). In addition, alcohol intake also increased the incidence of urolithiasis (OR = 1.0030, 95% CI:1.0009-1.0051, p = 0.005). In the UK biobank, the odds of urolithiasis increased per 1-SD increase of waist circumference (OR = 1.0215, 95% CI:1.0061-1.0372, p = 0.008) and body fat percentage (OR = 1.0239, 95% CI:1.0043-1.0440, p = 0.020). Surprisingly, we found that the risk of urolithiasis decreased with increasing hip circumference (OR = 0.9954, 95% CI:0.9915-0.9992, p = 0.017). In a meta-analysis of MR results, higher BMI (OR = 1.0016, 95% CI:1.0004-1.0027, p = 0.009), waist circumference (OR = 1.0073, 95% CI:1.0020-1.0126, p = 0.007), adiponectin (OR = 1.0026, 95% CI:1.0008-1.0043, p = 0.004), triglycerides (OR = 1.0015, 95% CI:1.0004-1.0026, p = 0.008) and body fat percentage (OR = 1.0104, 95% CI:1.0030-1.0178, p = 0.006) increased the risk of urolithiasis. Furthermore, alcohol intake also increased the incidence of urolithiasis (OR = 1.0033, 95% CI:1.0012-1.0053, p = 0.002). CONCLUSIONS Our MR study found that higher BMI, triglycerides, waist circumference, adiponectin, body fat percentage, and alcohol intake increased the risk of urolithiasis.
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Affiliation(s)
- Shusheng Zhu
- Department of Urology, Jining No. 1 People's Hospital, Jining, 272000, Shandong, China
| | - Yanpeng Fan
- Department of Urology, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Xia Hu
- Department of Geriatrics, Jining No. 1 People's Hospital, Jining, Shandong, China
| | - Mingming Shao
- Department of Urology, Jining No. 1 People's Hospital, Jining, 272000, Shandong, China.
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Laso García I, Gomez Dos Santos V, Sánchez Herranz A, Duque Ruiz G, Arias Fúnez F, Hevia Palacios M, Burgos Revilla FJ. Metabolic syndrome in calcium oxalate stones: Is it so important in this type of lithiasis? Actas Urol Esp 2022; 46:317-322. [PMID: 35570101 DOI: 10.1016/j.acuroe.2021.11.004] [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: 09/30/2021] [Accepted: 11/25/2021] [Indexed: 06/15/2023]
Abstract
INTRODUCTION AND OBJECTIVE The association of the metabolic syndrome with lithogenesis has been described, especially in uric acid stones. The aim of the work was to analyze the role of the metabolic syndrome in oxalocalcic lithogenesis. MATERIALS AND METHODS Metabolic evaluation of 151 patients including biochemical, hormonal and 24-urine urine parameters, as well as characteristics associated with metabolic syndrome. The relationship between the characteristics associated with the metabolic syndrome and those related to lithogenesis was evaluated using Spearman's correlation coefficient (SCC), Student's t test and Fisher's exact test. RESULTS The average body mass index (BMI) was 25.9 (SD 3.7). The median age was 51 years (18.6-84.8) and 64.9% were men. There were no statistically significant differences between hypertension and estradiol, testosterone, triglycerides or cholesterol (P=.191, .969, .454, .345, respectively). Regarding glucose, the mean was 114.5 and 93.5mg/dl in patients with and without hypertension (P=.000). The levels of glucose, estradiol, testosterone or cholesterol did not vary with proteinuria (P=.518, P=.227, P=.095, P=.218, respectively). The mean triglycerides were 185.6 and 108.2mg/dl in patients with and without proteinuria (P=.001). Hypertension and proteinuria were not associated (P=.586). BMI correlated with serum and urinary uric acid and urinary creatinine. CONCLUSIONS There are few associations between the characteristics of the metabolic syndrome and the anomalies related to lithogenesis. Metabolic syndrome does not seem to have a relevant role in the development of oxalocalcic stones.
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Affiliation(s)
- I Laso García
- Departamento de Urología, Hospital Universitario Ramón y Cajal, IRYCIS, Universidad de Alcalá, Madrid, Spain.
| | - V Gomez Dos Santos
- Departamento de Urología, Hospital Universitario Ramón y Cajal, IRYCIS, Universidad de Alcalá, Madrid, Spain
| | - A Sánchez Herranz
- Departamento de Bioquímica, Hospital Universitario Ramón y Cajal, IRYCIS, Universidad de Alcalá, Madrid, Spain
| | - G Duque Ruiz
- Departamento de Urología, Hospital Universitario Ramón y Cajal, IRYCIS, Universidad de Alcalá, Madrid, Spain
| | - F Arias Fúnez
- Departamento de Urología, Hospital Universitario Ramón y Cajal, IRYCIS, Universidad de Alcalá, Madrid, Spain
| | - M Hevia Palacios
- Departamento de Urología, Hospital Universitario Ramón y Cajal, IRYCIS, Universidad de Alcalá, Madrid, Spain
| | - F J Burgos Revilla
- Departamento de Urología, Hospital Universitario Ramón y Cajal, IRYCIS, Universidad de Alcalá, Madrid, Spain
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Dyslipidemia Increases the Risk of Incident Kidney Stone Disease in a Large Taiwanese Population Follow-Up Study. Nutrients 2022; 14:nu14071339. [PMID: 35405952 PMCID: PMC9000795 DOI: 10.3390/nu14071339] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 03/21/2022] [Accepted: 03/21/2022] [Indexed: 02/04/2023] Open
Abstract
The prevalence and incidence rates of kidney stone disease (KSD) in Taiwan are high; however, the association between lipid profile and KSD has yet to be investigated. The aim of this longitudinal study was to investigate the association between lipid profile with baseline and incident KSD in a large Taiwanese cohort. A total of 27,002 people enrolled in the Taiwan Biobank (TWB) were followed for a median of 4 years and classified into two groups according to whether they had (n = 1813; 6.7%) or did not have (n = 25,189; 93.3%) KSD at baseline. The presence of KSD was defined according to a self-reported history of kidney stones. The participants with baseline KSD (n = 1813) were excluded from the follow-up study, and the remaining participants were classified into two groups consisting of those who had (n = 640; 2.5%) or did not have (n = 24,549; 97.5%) incident KSD. After multivariable analysis, compared to quartile 1 of lipid profile, the participants in quartile 4 of triglycerides, quartiles 3 and 4 of high-density lipoprotein cholesterol (HDL-C), and quartile 4 of total cholesterol (Chol)/HDL-C ratio were significantly associated with baseline KSD. In the follow-up study, the participants in quartiles 2, 3, and 4 of triglycerides; quartile 2 of Chol; quartile 4 of HDL-C; quartile 3 of LDL-C; and quartiles 3 and 4 of Chol/HDL-C ratio were significantly associated with incident KSD. Our results showed that hypertriglyceridemia (67−93 mg/dL) was associated with a 1.463-fold increased risk of incident KSD and that low HDL-C (>63 mg/dL) protected against incident KSD formation. In addition, a Chol/HDL-C ratio larger than 3.64 was associated with a 1.381-fold increased risk of incident KSD. Our findings may imply that the optimal management of dyslipidemia may be associated with a lower risk of developing kidney stones.
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Laso García I, Gomez Dos Santos V, Sánchez Herranz A, Duque Ruiz G, Arias Fúnez F, Hevia Palacios M, Burgos Revilla F. Síndrome metabólico en los cálculos de oxalato cálcico: ¿es tan importante en este tipo de litiasis? Actas Urol Esp 2022. [DOI: 10.1016/j.acuro.2021.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Paulin MV, Dunn M, Vachon C, Beauchamp G, Conversy B. Association between hyperlipidemia and calcium oxalate lower urinary tract uroliths in dogs. J Vet Intern Med 2021; 36:146-155. [PMID: 34854133 PMCID: PMC8783332 DOI: 10.1111/jvim.16324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 11/11/2021] [Accepted: 11/17/2021] [Indexed: 11/28/2022] Open
Abstract
Background Metabolic syndrome is associated with formation of calcium oxalate (CaOx) uroliths in humans. Objectives To investigate the association between obesity and hyperlipidemia with CaOx lower urinary tract uroliths in client‐owned dogs. Animals Dogs with (n = 55, U [uroliths]‐dogs) and without (n = 39, UF [uroliths‐free]‐dogs) CaOx lower urinary tract uroliths. Methods Case‐control study. U‐dogs were retrospectively enrolled and compared to UF‐dogs. Body condition score (BCS; 1‐9 scoring scale), serum triglyceride (TG) and total cholesterol (CH) concentrations and glycemia (after >12‐hour food withholding) were recorded in both groups. Results On univariate logistic regression, when excluding Miniature Schnauzers, odds of having uroliths increased by a factor of 3.32 (95% CI 1.38‐11.12) for each mmol/L of TG (P = .027), of 39 (95% CI 9.27‐293.22) for each mmol/L of glycemia (P < .0001), and of 2.43 (95% CI 1.45‐4.45) per unit of BCS (P = .002). In multivariable models, the effect of TG was retained when all breeds were included for analysis and odds of having uroliths increased by a factor of 4.34 per mmol/L of TG (95% CI 1.45‐19.99; P = .02). Conclusions and Clinical Importance Serum lipid screening in dogs diagnosed with CaOx uroliths might be recommended to improve their medical staging and management.
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Affiliation(s)
- Mathieu V Paulin
- Department of Small Animal Clinical Sciences, Western College of Veterinary Medicine-University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Marilyn Dunn
- Department of Small Animal Clinical Sciences, Veterinary Teaching Hospital-University of Montreal, Saint-Hyacinthe, Quebec, Canada
| | - Catherine Vachon
- Department of Small Animal Clinical Sciences, Veterinary Teaching Hospital-University of Montreal, Saint-Hyacinthe, Quebec, Canada
| | - Guy Beauchamp
- Department of Small Animal Clinical Sciences, Veterinary Teaching Hospital-University of Montreal, Saint-Hyacinthe, Quebec, Canada
| | - Bérénice Conversy
- Department of Small Animal Clinical Sciences, Veterinary Teaching Hospital-University of Montreal, Saint-Hyacinthe, Quebec, Canada
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Chao Y, Gao S, Li N, Zhao H, Qian Y, Zha H, Chen W, Dong X. Lipidomics Reveals the Therapeutic Effects of EtOAc Extract of Orthosiphon stamineus Benth. on Nephrolithiasis. Front Pharmacol 2020; 11:1299. [PMID: 32973524 PMCID: PMC7472562 DOI: 10.3389/fphar.2020.01299] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 08/05/2020] [Indexed: 12/21/2022] Open
Abstract
Background Nephrolithiasis is a systemic metabolic disease with a high prevalence worldwide and is closely related to lipid-mediated oxidative stress and inflammation. Orthosiphon stamineus Benth. (OS) is a traditional medicinal herb mainly containing flavonoids, caffeic acid derivatives, and terpenoids, which has the effect of treating urinary stones. However, the active ingredients of OS for the treatment of kidney stones and their regulatory mechanisms remain unknown. As a powerful antioxidant, flavonoids from herbs can mitigate calcium oxalate stone formation by scavenging radical. Thus, this work focused on EtOAc extract of OS (EEOS, mainly flavonoids) and aimed to reveal the potential intrinsic mechanism of EEOS in the treatment of kidney stones disease. Methods Firstly, 75% ethanol extract of OS was further extracted with EtOAc to obtain EtOAc extract containing 88.82% flavonoids. Secondly, the extract was subjected to component analysis and used in animal experiments. Then, an untargeted lipidomics based on ultrahigh performance liquid chromatography coupled with TripleTOF 5600 mass spectrometer (UPLC-QTOF-MS) was performed to test the lipid changes of kidneys in the control group, model group and EEOS treatment groups. Finally, multivariate statistical analysis was used to identify differences between the lipid profiles of mice in the model group and the EEOS group. Results Fifty-one lipid metabolites were significantly different between the mice in the model group and the EEOS intervention group, including glycerophosphocholines, glycerophosphoethanolamines, glycerophosphoinositols, and glycerophosphoglycerols. And the composition of glycerophospholipids-esterified ω-3 polyunsaturated fatty acids and glycerophospholipid subclasses in the kidneys of the EEOS group significantly changed compared to model group. Conclusions The EEOS can inhibit the stones formation by improving oxidative stress and inflammation mediated by glycerophospholipid metabolism. This study reveals the potential mechanism of EEOS for kidney stones treatment at the lipid molecule level, providing a new direction for further study of the efficacy of OS.
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Affiliation(s)
- Yufan Chao
- School of Medicine, Shanghai University, Shanghai, China
| | - Songyan Gao
- Institute of Translational Medicine, Shanghai University, Shanghai, China
| | - Na Li
- School of Medicine, Shanghai University, Shanghai, China
| | - Hongxia Zhao
- School of Medicine, Shanghai University, Shanghai, China
| | - Yong Qian
- Shanghai Standard Technology Co., Ltd, Shanghai, China
| | - Haihong Zha
- SCIEX, Analytical Instrument Trading Co., Ltd, Shanghai, China
| | - Wei Chen
- Department of Nephrology, Shanghai Changhai Hospital, Shanghai, China
| | - Xin Dong
- School of Medicine, Shanghai University, Shanghai, China.,Institute of Translational Medicine, Shanghai University, Shanghai, China
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Chen M, Xiao J, Du Y, Wang M, Ruan J, Tian Y. Elevated non-high-density lipoprotein cholesterol corresponds to a high risk of nephrolithiasis in children. BMC Urol 2020; 20:120. [PMID: 32778076 PMCID: PMC7419197 DOI: 10.1186/s12894-020-00691-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 08/03/2020] [Indexed: 11/10/2022] Open
Abstract
Background Dyslipidemia contributes to the development of nephrolithiasis in adults; however its relationship to urolithiasis in children remains debatable, and will be clarified in the present work. Methods A case–control study was performed involving 58 pediatric patients diagnosed with upper urinary tract stones as well as 351 controls. Age, gender, body mass index (BMI), serum calcium, serum uric acid, blood glucose, blood lipids, and compositions of stones were compared. Results According to the univariate analysis, uric acid was higher (P < 0.01) but serum calcium lower in the stone group than the control (P < 0.05). As for the blood lipids, non-high-density lipoprotein cholesterol (non-HDL-c) was significantly higher in the stone group as compared to the control (P < 0.01), while total cholesterol, triglycerides, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol did not show statistical difference between the two groups. In the multivariate analysis, only non-HDL-c and serum uric acid were increased in the stone group (P = 0.003 and P = 0.008). In the stone compositions’ analysis, serum uric acid and non-HDL-c were associated with percentage of uric acid and pure calcium oxalate stones, respectively. Conclusion Non-high-density lipoprotein cholesterol may act as a lipid risk factor for urolithiasis in children.
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Affiliation(s)
- Meiyuan Chen
- Department of Urology, Beijing Friendship Hospital Affiliated to the Capital Medical University, No. 95, Yong'an Road, Xicheng District, Beijing, 100050, China.
| | - Jing Xiao
- Department of Urology, Beijing Friendship Hospital Affiliated to the Capital Medical University, No. 95, Yong'an Road, Xicheng District, Beijing, 100050, China
| | - Yuan Du
- Department of Urology, Beijing Friendship Hospital Affiliated to the Capital Medical University, No. 95, Yong'an Road, Xicheng District, Beijing, 100050, China
| | - Miaomiao Wang
- Department of Urology, Beijing Friendship Hospital Affiliated to the Capital Medical University, No. 95, Yong'an Road, Xicheng District, Beijing, 100050, China
| | - Jimeng Ruan
- Department of Urology, Beijing Friendship Hospital Affiliated to the Capital Medical University, No. 95, Yong'an Road, Xicheng District, Beijing, 100050, China
| | - Ye Tian
- Department of Urology, Beijing Friendship Hospital Affiliated to the Capital Medical University, No. 95, Yong'an Road, Xicheng District, Beijing, 100050, China.
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13
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Liu CJ, Wu JS, Huang HS. Decreased Associated Risk of Gout in Diabetes Patients with Uric Acid Urolithiasis. J Clin Med 2019; 8:jcm8101536. [PMID: 31557790 PMCID: PMC6832126 DOI: 10.3390/jcm8101536] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 09/11/2019] [Accepted: 09/23/2019] [Indexed: 12/04/2022] Open
Abstract
Uric acid urolithiasis constitutes approximately 7–10% of all urinary stones. Previous studies have revealed that patients with gout do not equally have uric acid stones. Instead, the risk of gout in patients with uric acid stones remains controversial. This study aimed to investigate whether there is different associated risk of gout for diabetes mellitus (DM) and non-diabetes patients with uric acid urolithiasis. Therefore, we examined all baseline chemistries to determine any risk factors or protective factors related to developing gout in patients with uric acid stones. Ninety-nine patients from a single medical center, who had a uric acid component in their stone specimen were enrolled and their medical records were reviewed retrospectively between January 2010 and December 2016. All patients were divided into gout and non-gout groups. Gout was confirmed in 24 patients in this study (24.2%). The proportion of DM was significantly higher in the non-gout group (34.7%) than in the gout group (4.3%, p < 0.05). Renal function was decreased and serum triglyceride was higher in patients with gout. Uric acid urolithiasis patients with DM had a lower risk for gout (adjusted odds ratio: 0.08; 95% confidence interval (CI) = 0.01–0.61, p = 0.015). In 89 patients with predominant uric acid stones (>50% uric acid composition), the risk for gout was still lower in patients with diabetes than non-diabetes (adjusted odds ratio: 0.08; 95% confidence interval (CI) = 0.01–0.61, p = 0.015). These findings suggest that decreased risk of gout is found in uric acid urolithiasis patients with diabetes. Our results imply that patients with uric acid stones should have complete diabetes evaluation before the administration of uric acid controlling medication.
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Affiliation(s)
- Chan Jung Liu
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan.
| | - Jin Shang Wu
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan.
- Department of Health Management Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan.
- Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan.
| | - Ho Shang Huang
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan.
- Department of Urology, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan.
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Cai C, Mai Z, Deng T, Zhao Z, Zhu W, Wen Y, Duan X, Wu W, Zeng G. Impact of dyslipidemia on 24-h urine composition in adults without urolithiasis. Lipids Health Dis 2018; 17:250. [PMID: 30400932 PMCID: PMC6220564 DOI: 10.1186/s12944-018-0899-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Accepted: 10/23/2018] [Indexed: 01/02/2023] Open
Abstract
PURPOSES To evaluate the influence of dyslipidemia on 24-h urine composition in adults who were non-stone formers (NF). METHODS Samples for 24-h urine composition were analyzed from 584 NF adults without urolithiasis in a national six-city-based epidemiologic study. The samples were divided into groups based on total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL), and low-density lipoprotein (LDL). The groups were compared based on demographic data and each component of 24-h urinalysis. RESULTS The numbers of participants in high TG, high TC, high LDL, and low HDL were 106, 175, 147, and 59, respectively. The high TG group had increased urinary excretions of oxalate [mean difference (MD) = 0.032 mmol, 95% confidence interval (CI): 0.000-0.065] and potassium (MD = 4.298 mmol, 95%CI: 0.182-8.414). Increased urinary excretion of calcium (MD = 0.531 mmol, 95%CI: 0.061-1.001), sodium (MD = 41.561 mmol, 95%CI: 9.179-73.942), and chloride (MD = 45.209 mmol, 95%CI: 12.118-78.299) were found in the high TC group. Interestingly, the high LDL group had a decreased urinary excretion of calcium (MD = - 0.573 mmol, 95%CI: -1.048 to - 0.097), oxalate (MD = - 0.038 mmol, 95%CI: -0.07 to - 0.006), sodium (MD = - 53.285 mmol, 95%CI: -85.823 to - 20.748), and chloride (MD = - 55.809 mmol, 95%CI: -89.035 to - 22.583). Increased urinary excretions of citrate (MD = 0.455 mmol, 95%CI: 0.076-0.835) and magnesium (MD = 0.697 mmol, 95%CI: 0.244-1.149) were found in the low HDL group. CONCLUSIONS The present study first investigated the effects of dyslipidemia on 24-h urinalysis in NF adults. Of note, high LDL and low HDL were found to be adversely related to kidney stone formation. However, people with high TG and high TC should be cautious of getting kidney stones.
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Affiliation(s)
- Chao Cai
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Guangzhou Institute of Urology, Guangzhou, China
- Guangdong Key Laboratory of Urology, Guangzhou, China
| | - Zanlin Mai
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Guangzhou Institute of Urology, Guangzhou, China
- Guangdong Key Laboratory of Urology, Guangzhou, China
| | - Tuo Deng
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Guangzhou Institute of Urology, Guangzhou, China
- Guangdong Key Laboratory of Urology, Guangzhou, China
| | - Zhijian Zhao
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Guangzhou Institute of Urology, Guangzhou, China
- Guangdong Key Laboratory of Urology, Guangzhou, China
| | - Wei Zhu
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Guangzhou Institute of Urology, Guangzhou, China
- Guangdong Key Laboratory of Urology, Guangzhou, China
| | - Yaoan Wen
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Guangzhou Institute of Urology, Guangzhou, China
- Guangdong Key Laboratory of Urology, Guangzhou, China
| | - Xiaolu Duan
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Guangzhou Institute of Urology, Guangzhou, China
- Guangdong Key Laboratory of Urology, Guangzhou, China
| | - Wenqi Wu
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Guangzhou Institute of Urology, Guangzhou, China
- Guangdong Key Laboratory of Urology, Guangzhou, China
| | - Guohua Zeng
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
- Guangzhou Institute of Urology, Guangzhou, China.
- Guangdong Key Laboratory of Urology, Guangzhou, China.
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15
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Chao Y, Gao S, Wang X, Li N, Zhao H, Wen X, Lou Z, Dong X. Untargeted lipidomics based on UPLC-QTOF-MS/MS and structural characterization reveals dramatic compositional changes in serum and renal lipids in mice with glyoxylate-induced nephrolithiasis. J Chromatogr B Analyt Technol Biomed Life Sci 2018; 1095:258-266. [DOI: 10.1016/j.jchromb.2018.08.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 07/28/2018] [Accepted: 08/06/2018] [Indexed: 12/17/2022]
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Besiroglu H, Ozbek E. Association between blood lipid profile and urolithiasis: A systematic review and meta-analysis of observational studies. Int J Urol 2018; 26:7-17. [PMID: 30151863 DOI: 10.1111/iju.13781] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 07/08/2018] [Indexed: 01/11/2023]
Abstract
The objective of this study was to pool individual studies regarding the association of blood lipid profiles with urolithiasis to carry out a systematic review and meta-analysis. We searched MEDLINE, PubMed, Embase and Cochrane Library to identify the relevant studies up to November 2017. Studies that met all inclusion criteria were chosen, and a pooled analysis of the odds ratio between urolithiasis and dyslipidemia traits was calculated. A total of 11 observational studies (seven cross-sectional, three cohort, one case-control) with a total of 282 479 participants were examined. The overall pooled analysis of eight studies showed that high triglyceride was associated with increased estimated risk of urolithiasis (odds ratio 1.287, 95% CI 1.073-1.544; P = 0.007). Estimates of the total effect size were consistent in the sensitivity analysis. No evidence of publication bias was detected. The overall pooled analysis of nine studies showed low high-density lipoprotein was weakly associated with increased estimated risk of urolithiasis (odds ratio 1.171, 95% CI 1.010-1.358; P = 0.032). The sensitivity analysis showed conflicting results. No evidence of publication bias was detected. Three studies on the association between any dyslipidemia traits and urolithiasis showed a significant association (odds ratio 1.309, 95% CI 1.202-1.425; P < 0.001). The present meta-analysis showed that patients with higher triglyceride and lower high-density lipoprotein had an increased estimated risk of urolithiasis. A triglyceride-urolithiasis association was found to be more coherent and consistent compared with the high-density lipoprotein-urolithiasis association. Although somewhat contradictory results have been found, the meta-analysis is encouraging for evaluating urolithiasis as a systemic disorder. Further well-designed prospective randomized controlled or cohort studies are necessary to better elucidate the causal association of dyslipidemia and urolithiasis.
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Affiliation(s)
- Huseyin Besiroglu
- Department of Urology, Catalca Ilyas Cokay State Hospital, Istanbul, Turkey
| | - Emin Ozbek
- Department of Urology, Cerrahpasa Medicine Faculty, Istanbul University, Istanbul, Turkey
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Yucel E, DeSantis S, Smith MA, Lopez DS. Association between low-testosterone and kidney stones in US men: The national health and nutrition examination survey 2011-2012. Prev Med Rep 2018; 10:248-253. [PMID: 29868376 PMCID: PMC5984232 DOI: 10.1016/j.pmedr.2018.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 03/07/2018] [Accepted: 04/01/2018] [Indexed: 12/29/2022] Open
Abstract
The purpose of this study was to determine the association between low-testosterone (total testosterone ≤3 ng/mL) and prevalence of kidney stones (KS) in men 20 years and older, and whether this varies by comorbidities, and race/ethnicity, and age. This was a cross-sectional study with data from the National Health and Nutrition Examination Survey (NHANES) 2011-2012 cycle. We found that men with low-testosterone had 41% lower odds of KS as compared to men without low-testosterone after multivariable adjustment (OR: 0.59, 95% CI 0.40-0.86). When stratified by obesity, obese men with low-testosterone had 59% lower odds of KS. When stratified by HDL, men with HDL ≥ 40 mg/dL and with low-testosterone had 40% lower odds of KS. When stratified by diabetes, men without diabetes with low-testosterone had 39% lower odds of KS, but the association was not significant in diabetic men with low-testosterone and other comorbidities. There were significant differences when stratified by race/ethnicity. Finally, when stratified by age, only the subgroup of men ≥40-<60 years old with low-testosterone had 68% lower odds of KS (OR: 0.32, 95% CI: 0.16-0.67). The association between low-testosterone and KS was inversed. Similar associations were identified when stratified by obesity, diabetes, dyslipidemia, race/ethnicity and age.
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Affiliation(s)
| | - Stacia DeSantis
- University of Texas Health Science Center at Houston, School of Public Health, 1200 Pressler Street, Houston, TX 77030, USA
| | - Mary A. Smith
- University of Texas Health Science Center at Houston, School of Public Health, 1200 Pressler Street, Houston, TX 77030, USA
| | - David S. Lopez
- University of Texas Health Science Center at Houston, School of Public Health, 1200 Pressler Street, Houston, TX 77030, USA
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18
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Cross-talk between renal lithogenesis and atherosclerosis: an unveiled link between kidney stone formation and cardiovascular diseases. Clin Sci (Lond) 2018; 132:615-626. [PMID: 29559506 DOI: 10.1042/cs20171574] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 01/10/2018] [Accepted: 01/12/2018] [Indexed: 12/19/2022]
Abstract
The prevalence of kidney stones and cardiovascular diseases (CVDs) are increasing throughout the world. Both diseases are chronic and characterized by accumulation of oxidized proteins and lipids in the renal tissue and arterial wall, respectively. Emerging studies have revealed a positive association between nephrolithiasis and CVDs. Based on preclinical and clinical evidences, this review discusses: (i) stone forming risk factors, crystal nucleation, aggregation, injury-induced crystal retention, and stone formation, (ii) CVD risk factors such as dyslipidemia, perturbation of gut microbiome, obesity, free radical-induced lipoprotein oxidation, and retention in the arterial wall, subsequent foam cell formation, and atherosclerosis, (iii) mechanism by which stone forming risk factors such as oxalate, calcium, uric acid, and infection contribute toward CVDs, and (iv) how CVD risk factors, such as cholesterol, phospholipids, and uric acid, contribute to kidney stone formation are described.
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Cohen AJ, Adamsky MA, Nottingham CU, Pruitt J, Lapin B, Wang CH, Park S. Impact of Statin Intake on Kidney Stone Formation. Urology 2018; 124:57-61. [PMID: 29421299 DOI: 10.1016/j.urology.2018.01.029] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 01/01/2018] [Accepted: 01/24/2018] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To determine whether statin intake affects nephrolithiasis risk, and whether higher lipid levels correlate with stone risk. Dyslipidemia is a known independent risk factor for urolithiasis, and emerging evidence suggests common biological pathways. Previous work has suggested that statins protect against new stone formation, but these findings have not been verified by other investigators. METHODS We queried our Institution's Electronic Data Warehouse for all patients who were newly diagnosed with hyperlipidemia between 2009 and 2011, and had never taken a statin drug. These patients' clinical outcomes were followed until 2015, to assess whether they had been newly prescribed statins and whether they had developed symptomatic urolithiasis. Patient demographics, stone risk factors, prescription data, and serum lipid values were collected. RESULTS A total of 101,259 patients met inclusion criteria, 47.8% of whom received a statin prescription during the study period. Patients prescribed statins were significantly older, had a greater likelihood of osteoporosis, hemiplegia, immobility, and more likely to take a thiazide diuretic. Patients without a history of urolithiasis who were started on statin therapy were significantly less likely to develop new stones than patients not taking statins. This protective effect was even greater in patients with a history of stone disease. Lipid parameters (low-density lipoprotein, triglyceride, cholesterol) were lower in the statin-treated group, suggesting overall compliance with these medications. CONCLUSION Our data confirm previous work that statins protect against urinary stone formation; however, the underlying mechanism seems to be distinct from statins' lipid-lowering effect.
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Affiliation(s)
- Andrew J Cohen
- Department of Surgery, Section of Urology, University of Chicago, Chicago, IL
| | - Melanie A Adamsky
- Department of Surgery, Section of Urology, University of Chicago, Chicago, IL.
| | | | - Jaclyn Pruitt
- Division of Urology, NorthShore University Health System, Evanston, IL
| | - Brittany Lapin
- Division of Urology, NorthShore University Health System, Evanston, IL
| | - Chi H Wang
- Division of Urology, NorthShore University Health System, Evanston, IL
| | - Sangtae Park
- Division of Urology, NorthShore University Health System, Evanston, IL
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Kirejczyk JK, Korzeniecka-Kozerska A, Baran M, Porowska H, Porowski T, Wasilewska A. Dyslipidaemia in overweight children and adolescents is associated with an increased risk of kidney stones. Acta Paediatr 2015; 104:e407-13. [PMID: 26096629 DOI: 10.1111/apa.13079] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Revised: 05/03/2015] [Accepted: 06/09/2015] [Indexed: 01/08/2023]
Abstract
AIM There is conflicting evidence about the role of obesity in paediatric nephrolithiasis. This Polish study explored the influence of nutritional status and lipid disturbances on urinary lithogenic factors and the risk of kidney stone formation in children and adolescents from three to 18 years of age. METHODS We carried out serum lipid profile evaluations and 24-h urine chemistry analyses on 493 overweight/obese paediatric participants (mean age 13 years) without nephrolithiasis and 492 healthy normal weight sex and age-matched controls. RESULTS A third (33%) of the study group had blood lipid disturbances, with more acidic urine, lower urinary citrate excretion and a higher fraction of ionised calcium and higher Bonn Risk Index than the controls. The participants' body mass index standard deviation score (BMI Z-score) was positively correlated with urinary oxalate and uric acid and negatively correlated with citrate excretion. Total cholesterol, low-density lipoprotein cholesterol and triglycerides correlated negatively with citraturia, while high-density lipoprotein cholesterol correlated positively. CONCLUSION The main factor that predisposed overweight and obese children to kidney stones was hypocitraturia. Urinary citrate excretion was related to both BMI Z-scores and all lipid fraction abnormalities. However, hypercholesterolaemia and particularly low-density lipoprotein hypercholesterolaemia seemed to play a major role.
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Affiliation(s)
- J K Kirejczyk
- Department of Paediatric Surgery; Medical University of Bialystok; Bialystok Poland
| | - A Korzeniecka-Kozerska
- Department of Paediatrics and Nephrology; Medical University of Bialystok; Bialystok Poland
| | - M Baran
- Department of Paediatrics, Endocrinology; Diabetology with Cardiology Division; Medical University of Bialystok; Bialystok Poland
| | - H Porowska
- Department of Medical Chemistry; Medical University of Bialystok; Bialystok Poland
| | - T Porowski
- Department of Paediatrics and Nephrology; Medical University of Bialystok; Bialystok Poland
| | - A Wasilewska
- Department of Paediatrics and Nephrology; Medical University of Bialystok; Bialystok Poland
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Masterson JH, Woo JR, Chang DC, Chi T, L'Esperance JO, Stoller ML, Sur RL. Dyslipidemia is associated with an increased risk of nephrolithiasis. Urolithiasis 2014; 43:49-53. [PMID: 25193087 DOI: 10.1007/s00240-014-0719-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2014] [Accepted: 08/27/2014] [Indexed: 11/30/2022]
Abstract
The pathophysiology of nephrolithiasis is multifactorial. Obesity, diabetes mellitus and hypertension are implicated in its formation. Dyslipidemia (DLD) recently has received attention as well. Congruent with a vascular etiology in stone formation, DLD theoretically would predispose patients to nephrolithiasis. We investigated a possible association of DLD with nephrolithiasis. A random cohort of 60,000 patients was established by collecting the first 5,000 patient charts per month in the year 2000. After excluding pediatric patients, a retrospective study was performed by reviewing age, sex, comorbidities, and last patient follow-up. Median lipid laboratory levels also were reviewed. Descriptive statistics were performed as well as Cox proportional-hazards regression analysis, and univariate and multivariate analyses. 52,184 (22,717 women/29,467 men) patient charts were reviewed. The average age was 31.0 ± 15.2 years. On univariate analysis, DLD was associated with nephrolithiasis with a hazard ratio (HR) of 2.2 [Confidence Interval (CI), 1.9-2.5; p < 0.001] and on multivariate analysis HR = 1.2 (1.0-1.5; p = 0.033). Low-density lipoprotein and triglycerides had no association with stone disease. Patients with high-density lipoprotein (HDL) values <45 for men and <60 for women had an HR of 1.4 (1.1-1.7, 95% CI, p = 0.003) on univariate analysis and on multivariate analysis; HR = 1.27 (1.03-1.56; p = 0.024) for nephrolithiasis. DLD was associated with an increased risk of stone disease though the only specific lipid panel associated with lower nephrolithiasis was HDL. Clinicians should consider obtaining lipid levels with the intent that treatment could potentially not only mitigate atherosclerotic disease but also decrease nephrolithiasis risk.
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Affiliation(s)
- James H Masterson
- Department of Urology, Naval Medical Center San Diego, San Diego, CA, USA,
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