Geraghty Robert M, Cook Paul, Roderick Paul, Somani Bhaskar
Department of Urology, Freeman Hospital, Newcastle-upon-Tyne NE7 7DN, UK.
Department of Biochemistry, University Hospital Southampton, Southampton SO16 6YD, UK.
J Clin Med. 2021 Mar 2;10(5):978. doi: 10.3390/jcm10050978.
Kidney stone formers (SF) are more likely to develop diabetes mellitus (DM), but there is no study examining risk of metabolic syndrome (MetS) in this population. We aimed to describe the risk of MetS in SF compared to non-SF.
SF referred to a tertiary referral metabolic centre in Southern England from 1990 to 2007, comparator patients were age, sex, and period (first stone) matched with 3:1 ratio from the same primary care database. SF with no documentation or previous MetS were excluded. Ethical approval was obtained and MetS was defined using the modified Association of American Clinical Endocrinologists (AACE) criteria. Analysis with cox proportional hazard regression.
In total, 828 SF were included after 1000 records were screened for inclusion, with 2484 age and sex matched non-SF comparators. Median follow-up was 19 years (interquartile range-IQR: 15-22) for both stone formers and stone-free comparators. SF were at significantly increased risk of developing MetS (hazard ratio-HR: 1.77; 95% confidence interval-CI: 1.55-2.03, < 0.001). This effect was robust to adjustment for pre-existing components (HR: 1.91; 95% CI: 1.66-2.19, < 0.001).
Kidney stone formers are at increased risk of developing metabolic syndrome. Given the pathophysiological mechanism, the stone is likely a 'symptom' of an underlying metabolic abnormality, whether covert or overt. This has implications the risk of further stone events and cardiovascular disease.
肾结石患者（SF）患糖尿病（DM）的可能性更高，但尚无研究调查该人群的代谢综合征（MetS）风险。我们旨在描述与非肾结石患者相比，肾结石患者患代谢综合征的风险。
1990年至2007年转诊至英格兰南部一家三级转诊代谢中心的肾结石患者，对照患者按年龄、性别和时期（首次结石）以3:1的比例从同一初级保健数据库中匹配。排除无记录或既往无代谢综合征的肾结石患者。获得伦理批准，并使用改良的美国临床内分泌学家协会（AACE）标准定义代谢综合征。采用Cox比例风险回归分析。
在筛选的1000条记录中，共纳入828例肾结石患者，有2484例年龄和性别匹配的非肾结石对照者。肾结石患者和无结石对照者的中位随访时间均为19年（四分位间距-IQR：15-22）。肾结石患者发生代谢综合征的风险显著增加（风险比-HR：1.77；95%置信区间-CI：1.55-2.03，<0.001）。对已存在的组分进行调整后，这种效应仍然显著（HR：1.91；95%CI：1.66-2.19），<0.001）。
肾结石患者发生代谢综合征的风险增加。鉴于病理生理机制，结石可能是潜在代谢异常的“症状”，无论其是隐匿的还是明显的。这对进一步发生结石事件和心血管疾病的风险具有影响。
