Kim Seolhye, Chang Yoosoo, Sung Eunju, Kim Cheol Hwan, Yun Kyung Eun, Jung Hyun-Suk, Shin Hocheol, Ryu Seungho
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.
PLoS One. 2017 Oct 26;12(10):e0184506. doi: 10.1371/journal.pone.0184506. eCollection 2017.
Non-alcoholic fatty liver disease (NAFLD), a hepatic manifestation or precursor of metabolic syndrome, may increase nephrolithiasis, a renal manifestation of insulin resistance, but the prospective association between NAFLD and incident nephrolithiasis has not been evaluated. We examined the association of NAFLD with the development of nephrolithiasis in a large cohort of Korean men and women.
We performed a cohort study of 208,578 Korean adults who underwent a health checkup examination between January 2002 and December 2014 and were followed-up annually or biennially through December 2014. NAFLD was defined as the presence of fatty liver in the absence of excessive alcohol use or other identifiable causes. Fatty liver and nephrolithiasis were determined based on ultrasonographic findings. We used a parametric Cox model to estimate the adjusted hazard ratios (HRs) of nephrolithiasis according to the presence of NAFLD.
During 1,054,887.6 person-year of follow-up, 16,442 participants developed nephrolithiasis. After adjusting for age, center, year of screening exam, smoking status, alcohol intake, physical activity, education level, body mass index, history of hypertension and diabetes, HOMA-IR, uric acid and C-reactive protein, male participants with NAFLD had a significantly increased risk of nephrolithiasis than those without NAFLD (adjusted HR 1.17, 95% CI 1.06-1.30). However, no association between NAFLD and nephrolithiasis was observed in women (adjusted HR 0.97, 95% CI 0.81-1.16).
In this large cohort study of young and middle-aged Koreans, NAFLD was significantly associated with an increased incidence of nephrolithiasis in men but not in women.
非酒精性脂肪性肝病（NAFLD）是代谢综合征的肝脏表现或先兆，可能增加肾结石的发生风险，而肾结石是胰岛素抵抗的肾脏表现，但NAFLD与新发肾结石之间的前瞻性关联尚未得到评估。我们在一大群韩国男性和女性中研究了NAFLD与肾结石发生之间的关联。
我们对208,578名韩国成年人进行了队列研究，这些人在2002年1月至2014年12月期间接受了健康检查，并在2014年12月前每年或每两年进行一次随访。NAFLD被定义为在无过量饮酒或其他可识别病因的情况下存在脂肪肝。根据超声检查结果确定脂肪肝和肾结石。我们使用参数Cox模型根据NAFLD的存在情况估计肾结石的调整后风险比（HRs）。
在1,054,887.6人年的随访期间，16,442名参与者发生了肾结石。在调整了年龄、中心、筛查年份、吸烟状况、饮酒量、身体活动、教育水平、体重指数、高血压和糖尿病病史、胰岛素抵抗稳态模型评估（HOMA-IR）、尿酸和C反应蛋白后，患有NAFLD的男性参与者患肾结石的风险显著高于未患NAFLD的男性（调整后HR为1.17，95%置信区间为1.06 - 1.30）。然而，在女性中未观察到NAFLD与肾结石之间的关联（调整后HR为0.97，95%置信区间为0.81 - 1.16）。
在这项针对韩国中青年的大型队列研究中
