Huang Ho Shiang, Liao Pao Chi, Liu Chan Jung
Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan.
Department of Urology, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan.
J Clin Med. 2020 Mar 8;9(3):729. doi: 10.3390/jcm9030729.
Previous studies have suggested that kidney stone formers are associated with a higher risk of cardiovascular events. To our knowledge, there have been no previous examinations of the relationship between carotid intima-media thickness (IMT) and urinary stone risk factors. This study was aimed toward an investigation of the association between dyslipidemia, IMT, and 24-hour urinalysis in patients with calcium oxalate (CaOx) or calcium phosphate (CaP) stones. We prospectively enrolled 114 patients with kidney stones and 33 controls between January 2016 and August 2016. All patients were divided into four groups, according to the stone compositions-CaOx ≥ 50% group, CaP group, struvite group, and uric acid stones group. Carotid IMT and the carotid score (CS) were evaluated using extracranial carotid artery doppler ultrasonography. The results of a multivariate analysis indicated that a higher serum total cholesterol (TC) and low-density lipoprotein (LDL) were all associated with lower urinary citrate and higher CS in both the CaOx ≥ 50% and CaP groups. Higher serum TC and LDL were also associated with increased serum 8-OHdG levels in both groups. The levels of carotid IMT and CS in the CaOx ≥ 50% and CaP groups were all significantly higher than in the controls. These findings suggest a strong link between dyslipidemia, carotid atherosclerosis, and calcium kidney stone disease.
先前的研究表明,肾结石患者发生心血管事件的风险较高。据我们所知,此前尚无关于颈动脉内膜中层厚度(IMT)与尿石症危险因素之间关系的研究。本研究旨在调查草酸钙(CaOx)或磷酸钙(CaP)结石患者的血脂异常、IMT与24小时尿液分析之间的关联。我们在2016年1月至2016年8月期间前瞻性纳入了114例肾结石患者和33例对照。根据结石成分,将所有患者分为四组——CaOx≥50%组、CaP组、鸟粪石组和尿酸结石组。使用颅外颈动脉多普勒超声评估颈动脉IMT和颈动脉评分(CS)。多变量分析结果表明,在CaOx≥50%组和CaP组中,较高的血清总胆固醇(TC)和低密度脂蛋白(LDL)均与较低的尿枸橼酸盐和较高的CS相关。较高的血清TC和LDL在两组中也与血清8-羟基脱氧鸟苷(8-OHdG)水平升高相关。CaOx≥50%组和CaP组的颈动脉IMT和CS水平均显著高于对照组。这些发现表明血脂异常、颈动脉粥样硬化与钙肾结石病之间存在密切联系。