Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
Int J Urol. 2011 Feb;18(2):131-8. doi: 10.1111/j.1442-2042.2010.02690.x. Epub 2010 Dec 22.
It has been reported that kidney stones are linked to metabolic syndrome (MetS), which is characterized by insulin resistance. The aim of the present study was to examine the association of insulin resistance, insulin and adiponectin with kidney stones in a Japanese population.
From February 2007 to March 2008, 1036 (529 men and 507 women) apparently healthy Japanese subjects, aged 35-79 years, were analyzed. Weight, height, waist circumference and blood pressure were measured. Overnight fasting blood was collected to measure insulin and adiponectin levels. Homeostasis model assessment of insulin resistance (HOMA-IR) was calculated to assess insulin resistance. Logistic regression analysis was used to estimate the odds ratio (OR) and 95% confidence intervals for a self-reported history of kidney stones across tertiles of HOMA-IR, insulin and adiponectin.
Of the participants, 84 men (15.6%) and 35 women (6.9%) had a history of kidney stones. Age, body mass index, waist circumference, systolic and diastolic blood pressures, HOMA-IR and insulin were significantly higher in women with than in women without kidney stones. There was no difference in adiponectin level between subjects with and without a history of kidney stones in either sex. Furthermore, a significant positive trend was observed in the age-adjusted OR for a history of kidney stones across insulin tertiles (P-value for trend = 0.04) in women.
For Japanese women, HOMA-IR and insulin are associated with a history of kidney stones. The findings suggest that MetS components could increase the risk of kidney stones through subclinical hyperinsulinemia and insulin resistance.
已有报道称肾结石与代谢综合征(MetS)有关,后者的特征为胰岛素抵抗。本研究旨在探讨日本人群中胰岛素抵抗、胰岛素和脂联素与肾结石之间的关系。
本研究纳入了 2007 年 2 月至 2008 年 3 月期间 1036 名(男 529 名,女 507 名)年龄在 35-79 岁之间的貌似健康的日本受试者。测量了受试者的体重、身高、腰围和血压。采集了过夜禁食血样以测量胰岛素和脂联素水平。使用稳态模型评估胰岛素抵抗(HOMA-IR)来评估胰岛素抵抗。使用 logistic 回归分析来估计 HOMA-IR、胰岛素和脂联素三分位数与肾结石史之间的比值比(OR)和 95%置信区间。
在参与者中,有 84 名男性(15.6%)和 35 名女性(6.9%)有肾结石史。与无肾结石史的女性相比,有肾结石史的女性年龄、体重指数、腰围、收缩压和舒张压、HOMA-IR 和胰岛素均显著更高。在两性中,有肾结石史的受试者与无肾结石史的受试者的脂联素水平均无差异。此外,女性肾结石史的年龄校正 OR 随着胰岛素三分位数的升高呈现出显著的正趋势(趋势 P 值=0.04)。
对于日本女性,HOMA-IR 和胰岛素与肾结石史相关。这些发现表明,代谢综合征成分可能通过亚临床高胰岛素血症和胰岛素抵抗增加肾结石的风险。