Subspecialty Service, Department of Veterans Affairs Medical Center, Augusta, GA, USA.
Department of Medicine, Section of Rheumatology, Georgia Regents University, Augusta, GA, USA.
J Bone Miner Res. 2015 Nov;30(11):2096-102. doi: 10.1002/jbmr.2553. Epub 2015 Jul 14.
Kidney and bladder stones (urinary tract stones) and osteoporosis are prevalent, serious conditions for postmenopausal women. Men with kidney stones are at increased risk of osteoporosis; however, the relationship of urinary tract stones to osteoporosis in postmenopausal women has not been established. The purpose of this study was to determine whether urinary tract stones are an independent risk factor for changes in bone mineral density (BMD) and incident fractures in women in the Women's Health Initiative (WHI). Data were obtained from 150,689 women in the Observational Study and Clinical Trials of the WHI with information on urinary tract stones status: 9856 of these women reported urinary tract stones at baseline and/or incident urinary tract stones during follow-up. Cox regression models were used to determine the association of urinary tract stones with incident fractures and linear mixed models were used to investigate the relationship of urinary tract stones with changes in BMD that occurred during WHI. Follow-up was over an average of 8 years. Models were adjusted for demographic and clinical factors, medication use, and dietary histories. In unadjusted models there was a significant association of urinary tract stones with incident total fractures (HR 1.10; 95% CI, 1.04 to 1.17). However, in covariate adjusted analyses, urinary tract stones were not significantly related to changes in BMD at any skeletal site or to incident fractures. In conclusion, urinary tract stones in postmenopausal women are not an independent risk factor for osteoporosis.
肾结石和膀胱结石(尿路结石)以及骨质疏松症是绝经后妇女常见的严重疾病。有肾结石的男性患骨质疏松症的风险增加;然而,尿路结石与绝经后妇女骨质疏松症之间的关系尚未确定。本研究的目的是确定尿路结石是否是妇女健康倡议(WHI)中女性骨密度(BMD)变化和骨折事件的独立危险因素。数据来自 WHI 观察研究和临床试验的 150689 名女性,其中包括尿路结石状态信息:这些女性中有 9856 人在基线时报告有尿路结石和/或随访期间有新发尿路结石。使用 Cox 回归模型确定尿路结石与骨折事件的关联,使用线性混合模型调查尿路结石与 WHI 期间发生的 BMD 变化的关系。随访时间平均超过 8 年。模型调整了人口统计学和临床因素、药物使用和饮食史。在未调整的模型中,尿路结石与总骨折事件的发生有显著相关性(HR 1.10;95%CI,1.04 至 1.17)。然而,在调整协变量的分析中,尿路结石与任何骨骼部位的 BMD 变化或骨折事件均无显著相关性。总之,绝经后妇女的尿路结石不是骨质疏松症的独立危险因素。