Department of Urology, Chungbuk National University College of Medicine, Cheongju, Korea.
Department of Urology, School of Medicine, Kyungpook National University, Daegu, Korea.
Investig Clin Urol. 2021 Mar;62(2):195-200. doi: 10.4111/icu.20200438.
Basal metabolic rate (BMR) is an indicator of overall body metabolism and may portend unique aberrations in urine physico-chemistry and stone recurrence. The present study examined the effect of predicted BMR on 24 hours urinary metabolic profiles and stone recurrence in obese stone patients.
Data from 308 obese patients (body mass index [BMI] ≥30 kg/m²) diagnosed with urinary stone disease between 2003 and 2015 were analyzed retrospectively. BMR was calculated using the Harris-Benedict equation, and patients were classified into two predicted BMR categories (<1,145 kcal/day, ≥1,145 kcal/day). Urinary metabolic parameters and risk of stone recurrence were compared between the two groups.
The high BMR group was more likely to be younger and female, and to have a high BMI and lower incidence of diabetes than the low BMR group (each p<0.05). There was a positive correlation between BMR and 24 hours urinary sodium, uric acid, and phosphate excretion. The amounts of stone-forming constituents such as calcium and uric acid were significantly higher in the high BMR group. Kaplan-Meier estimates showed that the high BMR group had a significantly shorter stone recurrence-free period than the low BMR group (log-rank test, p<0.001). Multivariate Cox regression analyses revealed that predicted BMR was an independent factor of stone recurrence (hazard ratio, 2.759; 95% confidence interval, 1.413-5.386; p=0.003).
BMR may be an easily measured parameter that can be used to identify risk of stone recurrence in obese stone patients.
基础代谢率（BMR）是全身代谢的指标，可能预示着尿液物理化学和结石复发的独特异常。本研究探讨了预测 BMR 对肥胖结石患者 24 小时尿液代谢谱和结石复发的影响。
回顾性分析了 2003 年至 2015 年间诊断为尿石病的 308 名肥胖患者（体重指数 [BMI]≥30kg/m²）的数据。使用 Harris-Benedict 方程计算 BMR，并将患者分为两个预测 BMR 类别（<1,145kcal/天，≥1,145kcal/天）。比较两组之间的尿液代谢参数和结石复发风险。
高 BMR 组更年轻、女性，BMI 更高，糖尿病发生率更低，而低 BMR 组则相反（均 p<0.05）。BMR 与 24 小时尿钠、尿酸和磷酸盐排泄量呈正相关。结石形成成分如钙和尿酸的量在高 BMR 组明显更高。Kaplan-Meier 估计表明，高 BMR 组的结石无复发期明显短于低 BMR 组（对数秩检验，p<0.001）。多变量 Cox 回归分析显示，预测 BMR 是结石复发的独立因素（危险比，2.759；95%置信区间，1.413-5.386；p=0.003）。
BMR 可能是一个易于测量的参数，可以用于识别肥胖结石患者的结石复发风险。
