Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts 04102, USA.
J Urol. 2011 Nov;186(5):1882-7. doi: 10.1016/j.juro.2011.06.067. Epub 2011 Sep 23.
Existing data on the relation between gallstones and kidney stones are provocative but limited. Therefore, we determined whether symptomatic radiographically confirmed gallstones (and/or cholecystectomy) and symptomatic kidney stone disease are independently associated.
We conducted cross-sectional and prospective analyses in the Nurses' Health Studies I and II (older and younger women, respectively) and the Health Professionals Follow-Up Study (men) that included more than 240,000 participants followed for 14 to 24 years. Regression models adjusted for age, body size, thiazide use, diet and other factors.
At baseline the multivariate odds ratio of kidney stone history in individuals with gallstone history compared to those without was 1.65 (95% CI 1.46-1.86) in older women, 1.85 (95% CI 1.65-2.07) in younger women and 1.61 (95% CI 1.41-1.85) in men. Prospectively, the multivariate relative risk of incident kidney stones in participants with gallstone history compared to those without was 1.26 (95% CI 1.09-1.44) in older women, 1.32 (95% CI 1.14-1.52) in younger women and 1.28 (95% CI 1.03-1.57) in men. The multivariate relative risk of incident gallstones in participants with kidney stone history compared to those without was 1.17 (95% CI 1.06-1.29) in older women, 1.31 (95% CI 1.19-1.45) in younger women and 1.51 (95% CI 1.35-1.68) in men. Prospective lag analyses instituting a delay of 4 years between the diagnoses of gallstones and kidney stones yielded similar results.
Gallstones and kidney stones are independently associated. Additional studies are needed to identify shared mechanisms underlying both diseases.
关于胆石症和肾结石之间关系的现有数据具有启发性，但很有限。因此，我们确定有症状的放射学确诊的胆石症（和/或胆囊切除术）和有症状的肾结石病是否独立相关。
我们在护士健康研究 I 和 II（年龄较大和较小的女性）和健康专业人员随访研究（男性）中进行了横断面和前瞻性分析，这些研究包括超过 240,000 名参与者，随访时间为 14 至 24 年。回归模型调整了年龄、体型、噻嗪类药物使用、饮食和其他因素。
在基线时，与无胆石症史的个体相比，有胆石症史的个体发生肾结石病史的多变量优势比在年龄较大的女性中为 1.65（95%CI 1.46-1.86），在年龄较小的女性中为 1.85（95%CI 1.65-2.07），在男性中为 1.61（95%CI 1.41-1.85）。前瞻性地，与无胆石症史的参与者相比，有胆石症史的参与者发生肾结石的多变量相对风险在年龄较大的女性中为 1.26（95%CI 1.09-1.44），在年龄较小的女性中为 1.32（95%CI 1.14-1.52），在男性中为 1.28（95%CI 1.03-1.57）。与无肾结石史的参与者相比，有肾结石史的参与者发生胆石症的多变量相对风险在年龄较大的女性中为 1.17（95%CI 1.06-1.29），在年龄较小的女性中为 1.31（95%CI 1.19-1.45），在男性中为 1.51（95%CI 1.35-1.68）。前瞻性的滞后分析在胆石症和肾结石的诊断之间设置了 4 年的延迟，得出了类似的结果。
胆石症和肾结石独立相关。需要进一步的研究来确定这两种疾病的共同发病机制。
