Lyall Vikram, Bartholomew Tyler, Pais Vernon
Clin Nephrol. 2025 Mar;103(3):193-199. doi: 10.5414/CN111499.
Free radical-mediated oxidative renal tubular injury secondary to hyperoxaluria is a proposed mechanism in the formation of calcium oxalate stones. Vitamin E, an important physiologic antioxidant, has been shown in rat models to prevent calcium oxalate crystal deposition. Our objective was to determine if low dietary vitamin E intake was associated with a higher incidence of stones.
We analyzed data from the 2017 to 2020 National Health and Nutrition Examination Survey, a nationally representative sample (n = 7,707). A multivariable logistic regression model was used to assess the association between elevated dietary vitamin E intake (≥ 15 mg/day) and nephrolithiasis controlling for key demographic variables: water and nutrient intake (sodium, calcium, vitamin C), and diabetes mellitus.
The incidence of nephrolithiasis was 1.66% (1.38% - 1.95%). In patients consuming < 15 mg/day vitamin E, the incidence was 1.8% compared to 0.8% in patients with vitamin E intake ≥ 15 mg/day (p = 0.024). In adjusted models, participants with low vitamin E intake had a significantly higher odds of reporting stone passage (aOR = 2.83, 95% CI (1.07 - 7.5)).
We found that low vitamin E intake is associated with a > 2.5× greater odds of stone passage. These data are consistent with animal models suggesting that vitamin E may play an important protective role in the pathogenesis of calcium oxalate stone formation. This is the first study assessing the relationship between vitamin E intake and nephrolithiasis in humans. Future investigation of vitamin E supplementation in stone formers may help further determine if vitamin E is useful in the management of calcium oxalate stones.
高草酸尿症继发的自由基介导的氧化性肾小管损伤是草酸钙结石形成的一种推测机制。维生素E是一种重要的生理抗氧化剂，在大鼠模型中已显示可预防草酸钙晶体沉积。我们的目的是确定低膳食维生素E摄入量是否与结石发病率较高相关。
我们分析了2017年至2020年全国健康与营养检查调查的数据，该调查是具有全国代表性的样本（n = 7707）。使用多变量逻辑回归模型评估膳食维生素E摄入量升高（≥15毫克/天）与肾结石之间的关联，并控制关键人口统计学变量：水和营养素摄入量（钠、钙、维生素C）以及糖尿病。
肾结石发病率为1.66%（1.38% - 1.95%）。维生素E摄入量<15毫克/天的患者发病率为1.8%，而维生素E摄入量≥15毫克/天的患者发病率为0.8%（p = 0.024）。在调整模型中，维生素E摄入量低的参与者报告有结石排出的几率显著更高（调整后的比值比 = 2.83，95%置信区间（1.07 - 7.5））。
我们发现低维生素E摄入量与结石排出几率高出2.5倍以上相关。这些数据与动物模型一致，表明维生素E可能在草酸钙结石形成的发病机制中起重要保护作用。这是第一项评估人类维生素E摄入量与肾结石之间关系的研究。未来对结石形成者补充维生素E的研究可能有助于进一步确定维生素E是否对草酸钙结石的管理有用。
