Timio Francesca, Kerry Sally M, Anson Ken M, Eastwood John B, Cappuccio Francesco P
Department of Community Health Sciences, St George's Hospital Medical School, London, UK.
Blood Press. 2003;12(2):122-7. doi: 10.1080/08037050310001084.
To determine whether stone-formers have higher BP than controls drawn from the general population and matched for age, sex and ethnic origin and to compare the relationship between sodium and calcium excretion in the two groups.
Thirty-six patients [mean (+/-standard deviation, SD) = 49.0 +/- 11.7 years; range 27-70 years] with kidney or ureteric stones and 108 controls (mean age of 49.6 +/- 6.8 years; range 39-61 years), matched for gender, ethnic origin and age group were studied. Patients and controls underwent physical measurements, a venous blood sample and they were asked to collect a 24-h urine sample for sodium, potassium, calcium and creatinine.
Stone-formers were significantly heavier and had higher BP than age-, sex- and ethnic-matched population controls. Whilst the difference in systolic BP was independent of the difference in body mass index [16.8 mmHg (7.2-26.4 mmHg), p = 0.001), the difference in diastolic BP was attenuated after adjustment for body mass [1.8 (-3.4 to 7.1), p = 0.49]. Stone-formers passed less urine than controls [-438 ml/day (95% CI -852 to -25), p = 0.038]. They had higher urinary calcium than controls [+3.7 mmol/day (2.8-4.6 mmol/day), p < 0.001], even when expressed as ratio to creatinine [+0.20 (0.11-0.29), p < 0.001]. Sodium excretion was positively associated with urinary calcium in both stone-formers and in controls. The slopes were comparable (0.92 vs 0.98 mmol Ca/100 mmol Na) so that for any level of sodium excretion (or salt intake), stone-formers had a higher calcium excretion than controls.
In stone-formers, the BP is higher than in controls. Stone-formers excrete more calcium than controls do. In stone-formers and controls, the relationship between urinary sodium and calcium is similar. Since this relationship results from an effect of sodium on calcium, a reduction in salt intake may be a useful method of reducing urinary calcium excretion in stone-formers. However, the "relative" hypercalciuria seen in stone-formers is independent of salt intake and may well reflect an underlying genetic predisposition.
确定结石形成者的血压是否高于从普通人群中选取的、年龄、性别和种族相匹配的对照组，并比较两组中钠和钙排泄之间的关系。
研究了36例患有肾结石或输尿管结石的患者[平均（±标准差，SD）=49.0±11.7岁；年龄范围27 - 70岁]以及108名对照组（平均年龄49.6±6.8岁；年龄范围39 - 61岁），两组在性别、种族和年龄组方面相匹配。患者和对照组接受了体格测量、采集静脉血样本，并被要求收集24小时尿液样本以检测钠、钾、钙和肌酐。
结石形成者比年龄、性别和种族匹配的人群对照组体重更重且血压更高。虽然收缩压的差异独立于体重指数的差异[16.8 mmHg（7.2 - 26.4 mmHg），p = 0.001]，但在调整体重后舒张压的差异减弱[1.8（-3.4至7.1），p = 0.49]。结石形成者的尿量比对照组少[-438 ml/天（95%可信区间-852至-25），p = 0.038]。他们的尿钙高于对照组[+3.7 mmol/天（2.8 - 4.6 mmol/天），p < 0.001]，即使以与肌酐的比值表示也是如此[+0.20（0.11 - 0.29），p < 0.001]。在结石形成者和对照组中，钠排泄与尿钙均呈正相关。斜率相当（0.92对0.98 mmol钙/100 mmol钠），因此对于任何水平的钠排泄（或盐摄入量），结石形成者的钙排泄量都高于对照组。
结石形成者的血压高于对照组。结石形成者比对照组排泄更多的钙。在结石形成者和对照组中，尿钠与尿钙之间的关系相似。由于这种关系是由钠对钙的作用导致的，减少盐摄入量可能是降低结石形成者尿钙排泄的一种有效方法。然而，结石形成者中出现的“相对”高钙尿症与盐摄入量无关，很可能反映了潜在的遗传易感性。
