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绝经后状态会增加尿酸结石的风险。

Postmenopausal status increases the risk of uric acid stones.

作者信息

Chou Yii-Her, Li Ching-Chia, Wu Wen-Jeng, Juan Yung-Shun, Chien Tsu-Ming

机构信息

Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.

Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Urology, Kaohsiung Medical University Gangshan Hospital, Kaohsiung, Taiwan; Department of Urology, School of Postbaccalaureate Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.

出版信息

Exp Gerontol. 2024 Oct 15;196:112570. doi: 10.1016/j.exger.2024.112570. Epub 2024 Sep 5.

Abstract

OBJECTIVE

This study investigated the impact of menopause on stone composition in women with urolithiasis.

STUDY DESIGN

A cross-sectional study was conducted from March 2013 to March 2018. Women with urolithiasis patients were divided into two groups according to their menopause status.

MAIN OUTCOME MEASURES

The clinical demographic characteristics, stone removal, stone composition, and urine chemistry were investigated. Univariate and multivariate survival analyses were performed to identify risk factors for the risk of uric acid stones.

RESULTS

Our study enrolled 1221 female patients with stone diseases, 783 (64.1 %) of whom were postmenopausal (66 patients surgically menopause and 717 patients naturally menopause). Postmenopausal women had higher rates of diabetes and hyperuricemia, a higher serum uric acid level, a higher urinary specific gravity, and a lower estimated glomerular filtration rate. Stone analysis revealed calcium oxalate stones in 66.2 % of the patients, apatite stones in 19.4 %, calcium oxalate and calcium phosphate stones in 7.7 %, uric acid stones in 4.4 %, struvite stones in 2.0 %, and brushite stones in 0.2 %. Postmenopausal women had a higher rate of uric acid stones. Multivariate analysis confirmed that postmenopausal status and hyperuricemia were independent risk factors of uric acid stones. Postmenopausal women required more invasive procedures to remove the stones, and they had lower self-voiding rates.

CONCLUSIONS

Postmenopausal women had higher rates of stone episodes, specifically related to uric acid stones. Given the prevalence and impact of chronic kidney diseases, factors that impede optimal renal function management in women must be identified to provide tailored treatment recommendations.

摘要

目的

本研究调查了绝经对尿石症女性结石成分的影响。

研究设计

2013年3月至2018年3月进行了一项横断面研究。尿石症女性患者根据绝经状态分为两组。

主要观察指标

调查临床人口统计学特征、结石清除情况、结石成分和尿液化学指标。进行单因素和多因素生存分析以确定尿酸结石风险的危险因素。

结果

我们的研究纳入了1221例患有结石疾病的女性患者,其中783例(64.1%)为绝经后女性(66例手术绝经,717例自然绝经)。绝经后女性患糖尿病和高尿酸血症的比例更高,血清尿酸水平更高,尿比重更高,估计肾小球滤过率更低。结石分析显示,66.2%的患者为草酸钙结石,19.4%为磷灰石结石,7.7%为草酸钙和磷酸钙结石,4.4%为尿酸结石,2.0%为鸟粪石结石,0.2%为透钙磷石结石。绝经后女性尿酸结石的发生率更高。多因素分析证实,绝经状态和高尿酸血症是尿酸结石的独立危险因素。绝经后女性需要更多的侵入性手术来清除结石,且自行排尿率较低。

结论

绝经后女性结石发作率较高,特别是与尿酸结石有关。鉴于慢性肾脏病的患病率和影响,必须确定阻碍女性最佳肾功能管理的因素,以提供针对性的治疗建议。

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