Handa Rajash K, Liu Ziyue, Connors Bret A, Alloosh Mouhamad, Basile David P, Tune Johnathan D, Sturek Michael, Evan Andrew P, Lingeman James E
Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, Indiana.
Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana.
J Urol. 2015 Apr;193(4):1409-16. doi: 10.1016/j.juro.2014.09.037. Epub 2014 Sep 22.
We performed a pilot study to assess whether renal shock wave lithotripsy influences metabolic syndrome onset and severity.
Three-month-old juvenile female Ossabaw miniature pigs were treated with shock wave lithotripsy (2,000 shock waves at 24 kV with 120 shock waves per minute in 2) or sham shock wave lithotripsy (no shock waves in 2). Shock waves were targeted to the upper pole of the left kidney to model treatment that would also expose the pancreatic tail to shock waves. Pigs were then instrumented to directly measure arterial blood pressure via an implanted radiotelemetry device. They later received a hypercaloric atherogenic diet for about 7 months. Metabolic syndrome development was assessed by the intravenous glucose tolerance test.
Metabolic syndrome progression and severity were similar in the sham treated and lithotripsy groups. The only exception arterial blood pressure, which remained relatively constant in sham treated pigs but began to increase at about 2 months towards hypertensive levels in lithotripsy treated pigs. Metabolic data on the 2 groups were pooled to provide a more complete assessment of metabolic syndrome development and progression in this juvenile pig model. The intravenous glucose tolerance test revealed substantial insulin resistance with impaired glucose tolerance within 2 months on the hypercaloric atherogenic diet with signs of further metabolic impairment at 7 months.
These preliminary results suggest that renal shock wave lithotripsy is not a risk factor for worsening glucose tolerance or diabetes mellitus onset. However, it appears to be a risk factor for early onset hypertension in metabolic syndrome.
我们进行了一项初步研究，以评估肾脏冲击波碎石术是否会影响代谢综合征的发生和严重程度。
对3个月大的幼年雌性奥萨巴微型猪进行冲击波碎石术（在24 kV下施加2000次冲击波，每分钟120次冲击波，共2次）或假冲击波碎石术（2次均无冲击波）。冲击波靶向左肾上极，以模拟同时使胰尾暴露于冲击波的治疗。然后通过植入的无线电遥测装置对猪进行仪器安装，以直接测量动脉血压。随后它们接受了约7个月的高热量致动脉粥样化饮食。通过静脉葡萄糖耐量试验评估代谢综合征的发展情况。
假治疗组和碎石术组的代谢综合征进展和严重程度相似。唯一的例外是动脉血压，在假治疗的猪中动脉血压保持相对稳定，但在碎石术治疗的猪中，动脉血压在约2个月时开始升高至高血压水平。将两组的代谢数据汇总，以更全面地评估该幼年猪模型中代谢综合征的发展和进展。静脉葡萄糖耐量试验显示，在高热量致动脉粥样化饮食的2个月内，存在明显的胰岛素抵抗和葡萄糖耐量受损，7个月时有进一步代谢受损的迹象。
这些初步结果表明，肾脏冲击波碎石术不是糖耐量恶化或糖尿病发病的危险因素。然而，它似乎是代谢综合征早期高血压发病的危险因素。
