Curhan G C, Willett W C, Rimm E B, Spiegelman D, Stampfer M J
Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115, USA.
Am J Epidemiol. 1996 Feb 1;143(3):240-7. doi: 10.1093/oxfordjournals.aje.a008734.
Patients with kidney stones are routinely advised to increase their fluid intake to decrease the risk of stone recurrence. However, there has been no detailed examination to determine whether the effect on recurrence varies by the type of beverage consumed. The authors conducted a prospective study of the relation between the intake of 21 different beverages and the risk of symptomatic kidney stones in a cohort of 45,289 men, 40-75 years of age, who had no history of kidney stones. Beverage use and other dietary information was measured by means of a semiquantitative food frequency questionnaire in 1986. During 6 years of follow-up (242,100 person-years), 753 incident cases of kidney stones were documented. After adjusting simultaneously for age, dietary intake of calcium, animal protein and potassium, thiazide use, geographic region, profession, and total fluid intake, consumption of specific beverages significantly added to the prediction of kidney stone risk (p < 0.001). After mutually adjusting for the intake of other beverages, the risk of stone formation decreased by the following amount for each 240-ml (8-oz) serving consumed daily: caffeinated coffee, 10% (95% confidence interval 4-15%); decaffeinated coffee, 10% (3-16%); tea, 14% (5-22%); beer, 21% (12-30%); and wine, 39% (10-58%). For each 240-ml serving consumed daily, the risk of stone formation increased by 35% (4-75%) for apple juice and 37% (1-85%) for grapefruit juice. The authors conclude that beverage type may have an effect on stone formation that involves more than additional fluid intake alone.
肾结石患者通常被建议增加液体摄入量，以降低结石复发风险。然而，尚未有详细研究来确定不同类型饮料对复发风险的影响是否存在差异。作者对45289名年龄在40至75岁、无肾结石病史的男性队列进行了一项前瞻性研究，探讨21种不同饮料的摄入量与有症状肾结石风险之间的关系。1986年通过半定量食物频率问卷对饮料摄入及其他饮食信息进行了测量。在6年的随访期（242100人年）内，记录到753例新发肾结石病例。在同时调整年龄、钙的饮食摄入量、动物蛋白、钾、噻嗪类药物使用、地理区域、职业和总液体摄入量后，特定饮料的消费显著增加了对肾结石风险的预测能力（p<0.001）。在相互调整其他饮料摄入量后，每天饮用每份240毫升（8盎司）的下列饮料，结石形成风险降低幅度如下：含咖啡因咖啡，10%（95%置信区间4-15%）；脱咖啡因咖啡，10%（3-16%）；茶，14%（5-22%）；啤酒，21%（12-30%）；葡萄酒，39%（10-58%）。每天饮用每份240毫升的苹果汁，结石形成风险增加35%（4-75%），葡萄柚汁增加37%（1-85%）。作者得出结论，饮料类型可能对结石形成有影响，这种影响不仅仅是额外的液体摄入。
