Department of Urology, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunwando-ro, Dong-gu, Ulsan, 44033, Korea.
World J Urol. 2022 Jul;40(7):1845-1851. doi: 10.1007/s00345-022-04047-7. Epub 2022 May 27.
Studies on howmetabolic syndrome affects renal stone progression in untreated asymptomatic patients are lacking. Therefore, we investigated the effect of metabolic syndrome on changes in renal stone size.
We retrospectively analyzed 820 patients with renal stones incidentally detected on CT during regular health examinations and who underwent follow-up CT evaluations for > 1 year. The patients were divided into two groups according to the presence of metabolic syndrome. Changes in stone size during the follow-up were assessed, and differences were compared according to various factors. Predictors of stone size change on CT were assessed using linear regression analysis.
Overall, 820 asymptomatic patients without a history of stone treatments and with a mean follow-up of 52.4 months were included. Of these, 104 (12.7%) had metabolic syndrome and 335 (40.9%) showed stone size increase during the follow-up. The stone size at diagnosis was not significantly different between patients with and without metabolic syndrome (225.3 ± 332.6 vs. 183.9 ± 310.2 mm, p = 0.159); however, a significant difference was observed in the change in stone size at follow-up (148.5 ± 352.0 vs. 81.5 ± 222.4 mm, p = 0.001). Multivariable analysis showed that age (β = - 0.11; - 5.92 to -0.69; p = 0.013), fasting glucose level ≥ 100 mg/dl (β = 0.11; 9.78-99.73; p = 0.017), and metabolic syndrome (β = 0.10; 9.78-99.73; p = 0.017) were factors predictive of stone size changes.
Metabolic syndrome, fasting glucose level ≥ 100 mg/dl and young age are positively related to renal stone size changes. Therefore, periodic follow-up and metabolic syndrome management are required in asymptomatic patients with renal stones, especially in young age.
缺乏代谢综合征对未经治疗的无症状患者肾结石进展影响的研究。因此，我们研究了代谢综合征对肾结石大小变化的影响。
我们回顾性分析了 820 例在常规健康检查中偶然发现 CT 肾结石的患者，并对其进行了随访 CT 评估>1 年。根据是否存在代谢综合征将患者分为两组。评估随访期间结石大小的变化，并根据各种因素比较差异。使用线性回归分析评估 CT 上结石大小变化的预测因素。
总体而言，纳入了 820 例无结石治疗史且平均随访时间为 52.4 个月的无症状患者。其中，104 例（12.7%）存在代谢综合征，335 例（40.9%）在随访期间结石大小增加。诊断时的结石大小在有代谢综合征和无代谢综合征的患者之间无显著差异（225.3±332.6 与 183.9±310.2 mm，p=0.159）；然而，在随访期间的结石大小变化方面存在显著差异（148.5±352.0 与 81.5±222.4 mm，p=0.001）。多变量分析显示，年龄（β=-0.11；-5.92 至-0.69；p=0.013）、空腹血糖水平≥100mg/dl（β=0.11；9.78-99.73；p=0.017）和代谢综合征（β=0.10；9.78-99.73；p=0.017）是预测结石大小变化的因素。
代谢综合征、空腹血糖水平≥100mg/dl 和年龄较小与肾结石大小变化呈正相关。因此，在无症状肾结石患者中，特别是在年轻患者中，需要定期随访和代谢综合征管理。
