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美国成年人残余胆固醇与肾结石风险的关系:2007-2016 年 NHANES 分析。

Relationship between remnant cholesterol and risk of kidney stones in U.S. Adults: a 2007-2016 NHANES analysis.

机构信息

Department of Urology, The People's Hospital of Yingshang, Yingshang, Anhui, China.

出版信息

Ann Med. 2024 Dec;56(1):2319749. doi: 10.1080/07853890.2024.2319749. Epub 2024 May 11.

Abstract

PURPOSE

Remnant cholesterol (RC) is the cholesterol content of triglyceride-rich lipoproteins. This study aimed to investigate the association between RC levels and kidney stones in U.S. adults.

METHODS

Data were obtained from the 2007 to 2016 National Health and Nutrition Examination Survey (NHANES). A total of 10,551 participants with complete data were included and analyzed in this study. Univariate and multivariate logistic regression analysis, restricted cubic spline function, subgroup analysis and mediation analysis were preformed to estimate the independent relationship between RC levels and kidney stones.

RESULTS

Participants with stone formation had higher levels of RC than those with without stone formation (25.78 ± 13.83 vs 23.27 ± 13.04, <0.001). The results of logistic regression analysis and dose-response risk curves revealed a positive nonlinear association between RC levels and risk of kidney stones [univariate: adjusted odds ratio (aOR) =2.388, 95% CI: 1.797-3.173, <0.001; multivariate: aOR = 1.424, 95% CI: 1.050-1.929,  =0.023]. Compared with the discordantly low RC group, the discordantly high RC group was associated with increased risk of kidney stones (aOR = 1.185, 95% CI: 1.013-1.386, =0.034). Similar results were demonstrated according to the discordance of different clinical cut points. And metabolic syndrome parameters and vitamin D levels parallelly mediated the association between RC and kidney stone risk.

CONCLUSIONS

Higher RC levels were independently associated with an increased risk of kidney stone incidence.

摘要

目的

残余胆固醇(RC)是富含甘油三酯的脂蛋白中的胆固醇含量。本研究旨在调查美国成年人中 RC 水平与肾结石之间的关系。

方法

数据来自 2007 年至 2016 年的国家健康和营养检查调查(NHANES)。本研究共纳入并分析了 10551 名数据完整的参与者。采用单变量和多变量逻辑回归分析、限制三次样条函数、亚组分析和中介分析来估计 RC 水平与肾结石之间的独立关系。

结果

有结石形成的参与者的 RC 水平高于无结石形成的参与者(25.78±13.83 与 23.27±13.04,<0.001)。逻辑回归分析和剂量反应风险曲线的结果显示,RC 水平与肾结石风险之间呈正非线性关联[单变量:调整后的优势比(aOR)=2.388,95%CI:1.797-3.173,<0.001;多变量:aOR=1.424,95%CI:1.050-1.929,=0.023]。与 RC 水平不一致低的组相比,RC 水平不一致高的组与肾结石风险增加相关(aOR=1.185,95%CI:1.013-1.386,=0.034)。根据不同临床切点的不一致性,也得到了相似的结果。代谢综合征参数和维生素 D 水平平行介导了 RC 与肾结石风险之间的关联。

结论

较高的 RC 水平与肾结石发病率增加独立相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4127/11089921/87994dca0bb7/IANN_A_2319749_F0001_B.jpg

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