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减重手术的潘多拉魔盒:揭示与肾结石风险的关联——一项横断面研究

The Pandora's Box of Bariatric Surgery: Unveiling the Association with Kidney Stone Risk-A Cross-Sectional Study.

作者信息

Wang Jinlong, Tian Liguo, Xiao Ping, Jiao Yan

机构信息

Department of First Operation Room, The First Hospital of Jilin University, Changchun, China.

Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, China.

出版信息

Obes Surg. 2025 Apr;35(4):1476-1483. doi: 10.1007/s11695-025-07795-8. Epub 2025 Mar 14.

Abstract

BACKGROUND

Metabolic and bariatric surgery is an effective intervention for severe obesity, known for improving comorbidities such as type 2 diabetes, hypertension, and hyperlipidemia. However, its association with kidney stone formation remains uncertain. This study investigates the relationship between bariatric surgery and kidney stone prevalence using data from NHANES 2015-2018.

METHODS

We conducted a cross-sectional analysis of 8,087 participants from NHANES (2015-2018). Bariatric surgery and kidney stone history were self-reported. Logistic regression models adjusted for demographic, clinical, and lifestyle factors were used to evaluate associations. Stratified analyses explored effect modification by subgroups.

RESULTS

Kidney stones were more prevalent among participants with bariatric surgery (26.57%) compared to those without (10.92%, P < 0.001). Bariatric surgery was associated with increased odds of kidney stones in the crude model (OR: 2.95, 95% CI: 1.57-5.55) and adjusted models (OR: 2.69, 95% CI: 1.27-5.70). Subgroup analyses highlighted stronger associations among females and participants with moderate physical activity.

CONCLUSION

Metabolic and bariatric surgery is linked to an elevated risk of kidney stones, influenced by demographic and clinical factors. Personalized counseling on hydration and dietary modifications is essential for mitigating this risk.

摘要

背景

代谢与减重手术是治疗重度肥胖的有效干预措施,以改善2型糖尿病、高血压和高脂血症等合并症而闻名。然而,其与肾结石形成之间的关联仍不确定。本研究利用2015 - 2018年美国国家健康与营养检查调查(NHANES)的数据,调查减重手术与肾结石患病率之间的关系。

方法

我们对NHANES(2015 - 2018年)的8087名参与者进行了横断面分析。减重手术和肾结石病史通过自我报告获得。使用针对人口统计学、临床和生活方式因素进行调整的逻辑回归模型来评估关联。分层分析探讨了亚组的效应修正。

结果

与未接受减重手术的参与者(10.92%)相比,接受减重手术的参与者中肾结石更为普遍(26.57%,P < 0.001)。在粗模型(比值比:2.95,95%置信区间:1.57 - 5.55)和调整模型(比值比:2.69,95%置信区间:1.27 - 5.70)中,减重手术与肾结石患病几率增加相关。亚组分析突出了女性和中度体力活动参与者之间更强的关联。

结论

代谢与减重手术与肾结石风险升高有关,受人口统计学和临床因素影响。关于补水和饮食调整的个性化咨询对于降低这种风险至关重要。

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