Zhang Fan, Li Wenjian
Changzhou Clinical College, Xuzhou Medical University, Changzhou, China.
Department of Endocrinology, Changzhou Third People's Hospital, Changzhou, China.
Kidney Blood Press Res. 2025;50(1):115-130. doi: 10.1159/000543404. Epub 2025 Jan 2.
This study aimed to investigate the potential association between the fatty liver index (FLI), metabolic dysfunction-associated steatotic liver disease (MASLD), and the risk of kidney stones using large-scale population-based data.
This study employed a cross-sectional design, utilizing data from the 2007 to 2018 National Health and Nutrition Examination Survey (NHANES) database. A total of 24,342 participants were enrolled in the study, and fatty liver status was assessed by calculating the FLI. MASLD was diagnosed by FLI in conjunction with cardiometabolic criteria. Data on the history of kidney stones were obtained by self-report. We employed logistic regression models to analyze the association between FLI, MASLD, and kidney stone risk and constructed multivariable adjustment models to control for potential confounders. Furthermore, we used restricted cubic spline curve models to investigate the dose-response relationship between FLI and kidney stone risk and conducted subgroup and interaction analyses.
The study's results indicate a strong correlation between increasing FLI quartiles and a notable rise in the prevalence of kidney stones. Specifically, the risk of developing kidney stones was 1.68 times higher among participants in the highest FLI quartile compared to those in the lowest. Furthermore, patients with MASLD exhibited a 1.35-fold increased risk of developing kidney stones compared to those with non-MASLD. Subgroup analyses demonstrated that the correlation between MASLD and kidney stone risk was consistent across multiple subgroups. However, a significant interaction was observed in the subgroups of smoking status, physical activity level, and hypertension (interaction p < 0.05). The restricted cubic spline analysis did not yield a statistically significant nonlinear association between FLI and kidney stone risk. However, the study did identify inflection point values for FLI.
This study demonstrated an association between FLI and MASLD and the risk of kidney stones. This suggests that these conditions may be pivotal risk factors for kidney stones. Further investigation is required to elucidate these associations' underlying mechanisms and develop efficacious interventions to reduce the risk of kidney stones. Also, formulating personalized prevention and treatment strategies for different population subgroups is paramount.
本研究旨在利用大规模基于人群的数据,调查脂肪肝指数(FLI)、代谢功能障碍相关脂肪性肝病(MASLD)与肾结石风险之间的潜在关联。
本研究采用横断面设计,利用2007年至2018年国家健康与营养检查调查(NHANES)数据库中的数据。共有24342名参与者纳入本研究,通过计算FLI评估脂肪肝状态。结合心脏代谢标准,通过FLI诊断MASLD。通过自我报告获取肾结石病史数据。我们采用逻辑回归模型分析FLI、MASLD与肾结石风险之间的关联,并构建多变量调整模型以控制潜在混杂因素。此外,我们使用受限立方样条曲线模型研究FLI与肾结石风险之间的剂量反应关系,并进行亚组和交互分析。
研究结果表明,FLI四分位数增加与肾结石患病率显著上升之间存在强相关性。具体而言,FLI最高四分位数的参与者患肾结石的风险是最低四分位数参与者的1.68倍。此外,与非MASLD患者相比,MASLD患者患肾结石的风险增加了1.35倍。亚组分析表明,MASLD与肾结石风险之间的相关性在多个亚组中一致。然而,在吸烟状态、身体活动水平和高血压亚组中观察到显著的交互作用(交互p<0.0)。受限立方样条分析未发现FLI与肾结石风险之间存在统计学显著的非线性关联。然而,该研究确实确定了FLI的拐点值。
本研究证明了FLI和MASLD与肾结石风险之间的关联。这表明这些情况可能是肾结石的关键危险因素。需要进一步研究以阐明这些关联的潜在机制,并制定有效的干预措施以降低肾结石风险。此外,为不同人群亚组制定个性化的预防和治疗策略至关重要。