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超重状态对儿童结石形成危险因素的作用:一项前瞻性研究。

Role of overweight status on stone-forming risk factors in children: a prospective study.

作者信息

Sarica Kemal, Eryildirim Bilal, Yencilek Faruk, Kuyumcuoglu Ugur

机构信息

Department of Urology, Yeditepe University Medical Faculty, Istanbul, Turkey.

出版信息

Urology. 2009 May;73(5):1003-7. doi: 10.1016/j.urology.2008.11.038. Epub 2009 Feb 4.

Abstract

OBJECTIVES

To evaluate the possible role of being overweight on stone-forming risk factors in children.

METHODS

A total of 94 children (43 boys and 51 girls, male/female ratio 1:1.8) who were taking no medication or dietary modifications before treatment were included in the study. After a detailed stone disease history, the systolic and diastolic blood pressures were precisely measured and recorded for all patients. The body mass index, 24-hour urine values, and serum stone-forming risk parameters were evaluated in 44 overweight (17 boys and 27 girls; group 1) and 50 normal (26 boys and 24 girls; group 2) children. The results of each group were compared using the Wilcoxon rank sum test.

RESULTS

The evaluation of the stone-forming risk factors in both groups revealed that the overweight status might be responsible for the increased excretion of these substances in such children. Most of the children in group 1 demonstrated hypocitraturia and hyperoxaluria (9/44, 20.5%) compared with the patients in group 2. Although the mean urinary oxalate level was 0.74 +/- 0.81 mg/kg/24 h for boys and 0.69 +/- 0.72 mg/kg/24 h for girls in group 1, relatively lower values were noted in group 2 (0.42 +/- 0.52 and 0.45 +/- 0.57 mg/kg/24 h for the boys and girls, respectively). Similarly, the children in group 1 had elevated mean urinary calcium and lower citrate excretion compared with the group 2 patients.

CONCLUSIONS

Overweight status in children might be associated with an elevated risk of stone formation in both sexes owing to the alterations in urine composition. Obese children could be more prone to stone formation, and they should be evaluated and followed up for this aspect.

摘要

目的

评估超重对儿童结石形成危险因素的可能作用。

方法

本研究纳入了94名在治疗前未服用药物或进行饮食调整的儿童(43名男孩和51名女孩,男女比例为1:1.8)。在详细询问结石病史后,精确测量并记录了所有患者的收缩压和舒张压。对44名超重儿童(17名男孩和27名女孩;第1组)和50名正常体重儿童(26名男孩和24名女孩;第2组)的体重指数、24小时尿液值和血清结石形成风险参数进行了评估。使用Wilcoxon秩和检验比较了每组的结果。

结果

两组结石形成危险因素的评估显示,超重状态可能是导致此类儿童这些物质排泄增加的原因。与第2组患者相比,第1组中的大多数儿童表现出低枸橼酸尿症和高草酸尿症(9/44,20.5%)。虽然第1组男孩的平均尿草酸水平为0.74±0.81mg/kg/24小时,女孩为0.69±0.72mg/kg/24小时,但第2组的数值相对较低(男孩和女孩分别为0.42±0.52和0.45±0.57mg/kg/24小时)。同样,与第2组患者相比,第1组儿童的平均尿钙升高,枸橼酸盐排泄降低。

结论

由于尿液成分的改变,儿童超重状态可能与两性结石形成风险升高有关。肥胖儿童可能更容易形成结石,对此应进行评估和随访。

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