Taylor Eric N, Stampfer Meir J, Curhan Gary C
Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass 02115, USA.
JAMA. 2005 Jan 26;293(4):455-62. doi: 10.1001/jama.293.4.455.
Larger body size may result in increased urinary excretion of calcium, oxalate, and uric acid, thereby increasing the risk for calcium-containing kidney stones. It is unclear if obesity increases the risk of stone formation, and it is not known if weight gain influences risk.
To determine if weight, weight gain, body mass index (BMI), and waist circumference are associated with kidney stone formation.
DESIGN, SETTING, AND PARTICIPANTS: A prospective study of 3 large cohorts: the Health Professionals Follow-up Study (N = 45,988 men; age range at baseline, 40-75 years), the Nurses' Health Study I (N = 93,758 older women; age range at baseline, 34-59 years), and the Nurses' Health Study II (N = 101,877 younger women; age range at baseline, 27-44 years).
Incidence of symptomatic kidney stones.
We documented 4827 incident kidney stones over a combined 46 years of follow-up. After adjusting for age, dietary factors, fluid intake, and thiazide use, the relative risk (RR) for stone formation in men weighing more than 220 lb (100.0 kg) vs men less than 150 lb (68.2 kg) was 1.44 (95% confidence interval [CI], 1.11-1.86; P = .002 for trend). In older and younger women, RRs for these weight categories were 1.89 (95% CI, 1.52-2.36; P<.001 for trend) and 1.92 (95% CI, 1.59-2.31; P<.001 for trend), respectively. The RR in men who gained more than 35 lb (15.9 kg) since age 21 years vs men whose weight did not change was 1.39 (95% CI, 1.14-1.70; P = .001 for trend). Corresponding RRs for the same categories of weight gain since age 18 years in older and younger women were 1.70 (95% CI, 1.40-2.05; P<.001 for trend) and 1.82 (95% CI, 1.50-2.21; P<.001 for trend). Body mass index was associated with the risk of kidney stone formation: the RR for men with a BMI of 30 or greater vs those with a BMI of 21 to 22.9 was 1.33 (95% CI, 1.08-1.63; P<.001 for trend). Corresponding RRs for the same categories of BMI in older and younger women were 1.90 (95% CI, 1.61-2.25; P<.001 for trend) and 2.09 (95% CI, 1.77-2.48; P<.001 for trend). Waist circumference was also positively associated with risk in men (P = .002 for trend) and in older and younger women (P<.001 for trend for both).
Obesity and weight gain increase the risk of kidney stone formation. The magnitude of the increased risk may be greater in women than in men.
体型较大可能导致钙、草酸盐和尿酸的尿排泄增加，从而增加含钙肾结石的风险。目前尚不清楚肥胖是否会增加结石形成的风险，也不清楚体重增加是否会影响风险。
确定体重、体重增加、体重指数（BMI）和腰围是否与肾结石形成有关。
设计、设置和参与者：对3个大型队列进行的前瞻性研究：健康专业人员随访研究（N = 45988名男性；基线年龄范围为40 - 75岁）、护士健康研究I（N = 93758名老年女性；基线年龄范围为34 - 59岁）和护士健康研究II（N = 101877名年轻女性；基线年龄范围为27 - 44岁）。
有症状肾结石的发病率。
在总计46年的随访中，我们记录了4827例新发肾结石病例。在调整年龄、饮食因素、液体摄入量和噻嗪类药物使用情况后，体重超过220磅（100.0千克）的男性与体重不足150磅（68.2千克）的男性相比，结石形成的相对风险（RR）为1.44（95%置信区间[CI]，1.11 - 1.86；趋势P = 0.002）。在老年女性和年轻女性中，这些体重类别的RR分别为1.89（95%CI，1.52 - 2.36；趋势P<0.001）和1.92（95%CI，1.59 - 2.31；趋势P<0.001）。21岁后体重增加超过35磅（15.9千克）的男性与体重未变化的男性相比，RR为1.39（95%CI，1.14 - 1.70；趋势P = 0.001）。在18岁后体重增加相同类别的老年女性和年轻女性中，相应的RR分别为1.70（95%CI，1.40 - 2.05；趋势P<0.001）和1.82（95%CI，1.50 - 2.21；趋势P<0.001）。体重指数与肾结石形成风险相关：BMI为30或更高的男性与BMI为21至22.9的男性相比，RR为1.33（95%CI，1.08 - 1.63；趋势P<0.001）。在老年女性和年轻女性中，相同BMI类别的相应RR分别为1.90（95%CI，1.61 - 2.25；趋势P<0.001）和2.09（95%CI，1.77 - 2.48；趋势P<0.001）。腰围在男性（趋势P = 0.002）以及老年女性和年轻女性中（两者趋势P<0.001）也与风险呈正相关。
肥胖和体重增加会增加肾结石形成的风险。女性风险增加的幅度可能大于男性。
Zotero 插件