Sarica Kemal, Altay Bulent, Erturhan Sakip
Department of Urology, Memorial Hospital, Istanbul, Turkey.
Urology. 2008 May;71(5):771-4; discussion 774-5. doi: 10.1016/j.urology.2007.11.164. Epub 2008 Mar 12.
To evaluate the possible role of being overweight on stone-forming risk factors.
A total of 264 patients were included in the study. After a detailed stone disease history, the systolic and diastolic blood pressure was precisely measured and recorded for all patients, and the body mass index, 24-hour urine composition, and serum stone-forming risk parameters were evaluated in overweight (n = 164; 52 men and 112 women; group 1) and normal (n = 100; 44 men and 56 women, group 2) patients. Of the 264 patients, 110 were men and 154 were women (male/female ratio 1:1.4); none had undergone any medical or dietetic treatment before study entry.
The evaluation of the stone-forming risk factors in both groups revealed that obesity increased the excretion of these substances in group 1. Of the 164 patients in group 1, most (58; 35.3%) demonstrated hyperoxaluria compared with group 2 (P <0.001). Also, the mean urinary oxalate level was 44.91 +/- 24.89 mg/24 hours in group 1 and was 26.67 +/- 24.59 mg/24 hours in group 2 (P <0.001). Similarly, patients in group 1 had elevated mean urinary calcium excretion and lower citrate excretion compared with those in group 2 (P = 0.045 and P = 0.032, respectively).
Our results have clearly shown that being overweight might be associated with an elevated risk of stone formation in both sexes owing to alterations in urine composition. People who are overweight could be more prone to stone formation and should be carefully evaluated and followed up regarding this aspect.
评估超重对结石形成危险因素的可能作用。
本研究共纳入264例患者。在详细了解结石病史后,精确测量并记录所有患者的收缩压和舒张压,并对超重患者(n = 164;52名男性和112名女性;第1组)和正常体重患者(n = 100;44名男性和56名女性,第2组)的体重指数、24小时尿液成分及血清结石形成风险参数进行评估。264例患者中,男性110例,女性154例(男/女比例为1:1.4);在研究入组前均未接受过任何药物或饮食治疗。
两组结石形成危险因素评估显示,肥胖使第1组这些物质的排泄增加。第1组164例患者中,大多数(58例;35.3%)表现为高草酸尿症,与第2组相比差异有统计学意义(P <0.001)。此外,第1组尿草酸平均水平为44.91±24.89mg/24小时,第2组为26.67±24.59mg/24小时(P <0.001)。同样,与第2组相比,第1组患者尿钙平均排泄量升高,枸橼酸盐排泄量降低(分别为P = 0.045和P = 0.032)。
我们的结果清楚地表明,超重可能由于尿液成分改变而使两性结石形成风险升高。超重者可能更易形成结石,对此方面应进行仔细评估和随访。