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成人超声诊断肾结石与亚临床冠状动脉钙化的相关性研究。

Association Between Sonographically Diagnosed Nephrolithiasis and Subclinical Coronary Artery Calcification in Adults.

机构信息

Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.

Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea.

出版信息

Am J Kidney Dis. 2018 Jan;71(1):35-41. doi: 10.1053/j.ajkd.2017.06.026. Epub 2017 Aug 18.

Abstract

BACKGROUND

Although recent studies suggest an association between nephrolithiasis and clinical cardiovascular events, this association has been underexplored.

STUDY DESIGN

Cross-sectional study.

SETTING & PARTICIPANTS: 62,091 asymptomatic adults without known coronary heart disease who underwent a screening health examination that included cardiac tomography.

PREDICTOR

Nephrolithiasis.

OUTCOME

Coronary artery calcification (CAC).

MEASUREMENTS

Nephrolithiasis assessed using ultrasonography of the abdomen. CAC scoring assessed using cardiac computed tomography.

RESULTS

The prevalence of CAC scores > 0 was 13.1% overall. Participants with nephrolithiasis had a higher prevalence of coronary calcification than those without (19.1% vs 12.8%). In Tobit models adjusted for age and sex, the CAC score ratio comparing participants with nephrolithiasis with those without nephrolithiasis was 1.56 (95% CI, 1.19-2.05). After further adjustment for screening center, year of screening examination, physical activity, alcohol intake, smoking status, education level, body mass index, family history of cardiovascular disease, total energy intake, glucose concentration, systolic blood pressure, triglyceride concentration, high-density lipoprotein cholesterol concentration, uric acid concentration, and estimated glomerular filtration rate, the CAC score ratio was attenuated, but remained significant (CAC score ratio, 1.31; 95% CI, 1.00-1.71).

LIMITATIONS

Computed tomographic diagnosis of nephrolithiasis was unavailable.

CONCLUSIONS

Nephrolithiasis was associated with the presence of CAC in adults without known coronary heart disease, supporting the hypothesis that these 2 health conditions share a common pathophysiology.

摘要

背景

尽管最近的研究表明肾结石与临床心血管事件之间存在关联,但这一关联尚未得到充分探讨。

研究设计

横断面研究。

设置和参与者

62091 名无症状且无已知冠心病的成年人,他们接受了包括心脏计算机断层扫描在内的筛查体检。

预测因子

肾结石。

结果

冠状动脉钙化(CAC)。

测量

使用腹部超声评估肾结石。使用心脏计算机断层扫描评估 CAC 评分。

结果

总体而言,CAC 评分>0 的患病率为 13.1%。患有肾结石的参与者比没有肾结石的参与者有更高的冠状动脉钙化患病率(19.1%比 12.8%)。在调整年龄和性别后的 Tobit 模型中,比较肾结石患者和无肾结石患者的 CAC 评分比值为 1.56(95%CI,1.19-2.05)。进一步调整筛查中心、筛查检查年份、身体活动、酒精摄入量、吸烟状况、教育水平、体重指数、心血管疾病家族史、总能量摄入、葡萄糖浓度、收缩压、甘油三酯浓度、高密度脂蛋白胆固醇浓度、尿酸浓度和估计肾小球滤过率后,CAC 评分比值减弱,但仍具有统计学意义(CAC 评分比值,1.31;95%CI,1.00-1.71)。

局限性

无法通过计算机断层扫描诊断肾结石。

结论

在无已知冠心病的成年人中,肾结石与 CAC 的存在相关,这支持了这两种健康状况具有共同病理生理学的假设。

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