Zhang Weiyu, Lou Benxing, Peng Yu, Wu Feng, Zhang Dan, Wang Qi
Department of Urology, Peking University People's Hospital, Beijing, China.
The Institute of Applied Lithotripsy Technology, Peking University, Beijing, China.
Medicine (Baltimore). 2024 Dec 13;103(50):e40778. doi: 10.1097/MD.0000000000040778.
Kidney stones formation is a multifactorial condition and influenced, in some degree, by dietary habits. Authoritative clinical guidelines published nutritional recommendations for individuals prone to kidney stone formation. The association between dietary intake calcium to phosphorus (Ca/P) ratios and the prevalence of kidney stones is not well-established in extensive epidemiological studies. Data from the National Health and Nutrition Examination Survey 2017 to 2018 database were utilized in this study. A total of 3 149 participants with a history of kidney stones were enrolled in the present analysis. The participants were categorized into 4 groups based on their dietary Ca/P ratio, divided by quartiles, with quartile 1 representing the lowest ratio and quartile 4 indicating the highest ratio. We applied survey-weighting to all the data and conducted logistic regression models to assess the connections between Ca/P ratio and the likelihood of developing kidney stones. We utilized restricted cubic spline analysis to assess the nonlinear relationship between dietary Ca/P ratio intake and the risk of kidney stones. In a fully adjusted model referred by quartile 1, participants in quartile 4 had a significantly higher rate of kidney stones (odds ratio 1.5697, P < .001). Compared with single calcium or phosphorus consumption, the Ca/P ratio was found to be a better predictor of the risk of kidney stones. The quartile analysis suggested an appropriate Ca/P ratio of 0.5513 to 0.6810 to meet a lower risk of kidney stones. There was a significant association between dietary Ca/P ratio intake and the risk of kidney stones. A moderate intake of dietary Ca/P ratio was recommended.
肾结石的形成是一种多因素疾病，在一定程度上受饮食习惯影响。权威临床指南针对易患肾结石的个体发布了营养建议。在广泛的流行病学研究中，饮食中钙磷（Ca/P）比值与肾结石患病率之间的关联尚未明确确立。本研究使用了2017年至2018年国家健康与营养检查调查数据库的数据。本分析共纳入了3149名有肾结石病史的参与者。根据饮食Ca/P比值将参与者分为4组，按四分位数划分，四分位数1代表最低比值，四分位数4代表最高比值。我们对所有数据应用了调查加权，并进行逻辑回归模型以评估Ca/P比值与患肾结石可能性之间的联系。我们使用受限立方样条分析来评估饮食Ca/P比值摄入量与肾结石风险之间的非线性关系。在以四分位数1为参照的完全调整模型中，四分位数4的参与者患肾结石的比率显著更高（比值比1.5697，P <.001）。与单独摄入钙或磷相比，发现Ca/P比值是肾结石风险的更好预测指标。四分位数分析表明，适当的Ca/P比值为0.5513至0.6810，以降低患肾结石的风险。饮食Ca/P比值摄入量与肾结石风险之间存在显著关联。建议适度摄入饮食Ca/P比值。
