Elsevier

Metabolism

Volume 62, Issue 6, June 2013, Pages 808-813
Metabolism

Clinical Science
Association of nephrolithiasis with metabolic syndrome and its components

https://doi.org/10.1016/j.metabol.2012.12.010Get rights and content

Abstract

Objective

Both metabolic syndrome (MetS) and nephrolithiasis (NL) are common and clinically important disorders. Therefore, we conducted this study to assess the association of MetS and NL.

Materials/Methods

Data were obtained from 116,536 individuals who underwent health screening tests between January 2010 and December 2010 at a health promotion center in Seoul, Korea. All subjects were asked to respond to a questionnaire including medical history of each subject. Anthropometric and biochemical measurements were applied to each subject. Presence of NL was evaluated by an abdominal ultrasonography. The subjects were classified into MetS and non-MetS group according to the criteria for MetS (National Cholesterol Education Program Adult Treatment Panel III). Compared to the non-MetS group, we estimated the Odds Ratios (ORs) and 95% Confidence Intervals (CIs) of the presence of NL in the MetS group adjusting for age, serum levels of creatinine and uric acid, and past medical history of NL based on the multivariate logistic regression analysis.

Results

The prevalence of MetS was 15.9% (N = 1129/7107) in the NL group, and 11.2% (N = 12,287/109,429) in the non-NL group, respectively. After adjusting for the potential confounding factors, male MetS patients had a higher presence of NL than non-MetS subjects (OR 1.11; 95% CI 1.02–1.20; p = 0.01). Of MetS components, only high blood pressure (BP) was a significantly related factor to the presence of NL (male; OR 1.08; 95% CI 1.01–1.15; p = 0.043, female; OR 1.24; 95% CI 1.08–1.42; p = 0.002). As the number MetS components increased, the presence of NL was significantly higher in male subjects (P for trend < 0.001), but not in female subjects (P for trend = 0.961).

Conclusions

We found that NL was associated with MetS and high BP.

Introduction

The prevalence of metabolic syndrome (MetS) in Korea was 24.1 % (male 27.4%, female 20.9%) in 2005 (the 3rd Korea National Health and Nutrition Examination Survey), and has been increasing [1]. MetS was positively associated with the morbidity and mortality from cardiovascular diseases and type II diabetes mellitus (DM) [2], [3], [4].Nephrolithiasis (NL) is also a common disorder with lifetime cumulative incidence of 5%–10%, and the prevalence of NL has increased worldwide recently [5], [6]. The origin of NL is multifactorial, with epidemiologic studies showing that hypertension, obesity, and excessive meat consumption are associated with stone formation [7], [8]. Several studies have suggested that MetS, which is a condition clinically defined by a clustering of abdominal obesity, dyslipidemia, elevated blood pressure (BP) and elevated fasting plasma glucose (FPG), was linked directly to the formation of NL. A large study about the association of NL with MetS (NHANES III 1988–1994) reported that patients with two or more components of MetS had a higher presence of NL [9]. A study on Caucasian patients admitted to hospital also showed MetS was an independent risk factor for the presence of NL (Odds ratio (OR): 2.0, 95% confidence intervals (CIs): 1.3–3.0) [10]. A recent Korean study reported that Mets had a significant relation with the presence of NL (OR: 1.25, 95% CI: 1.03–1.50) [11].

Although there have been many studies on the association between MetS and NL, it is still unclear that MetS is an independent risk factor for NL, and whether each component of MetS is associated with NL. We therefore conducted this study based on a large population who visited a health promotion center to assess whether MetS and each component of MetS were associated with the presence of NL.

Section snippets

Study population

The study subjects were people who visited the Health Promotion Center of the Kangbuk Samsung Hospital, from January to December in 2010. All study subjects (n = 119,519) were aged 18 and above. Each subject responded to a questionnaire by his or herself, and was interviewed with regard to personal medical history by trained nurses. The questionnaire included demographic characteristics (age, sex); past medical history of hypertension, DM, dyslipidemia, NL, ischemic heart disease, stroke, cancer,

Result

Male subjects had a higher prevalence of MetS and NL than females. Compared to the subjects without NL, the patients with NL were older and had higher serum levels of UA and Cr (lower eGFR), and more past medical history for NL. The prevalence of MetS in the patients with NL was higher than the subjects without NL (15.9% vs. 11.2%, p < 0.001). The prevalence of all of the five components for the MetS criteria was significantly different between the patients with NL and the subjects without NL

Discussion

Our study on a large population of Korean adults who visited a health promotion center demonstrated that MetS in male subjects and high BP in both male and female subjects were significantly associated with the presence of NL after adjusting for age, serum levels of Cr and UA, and past medical history of NL. We also noted that as the number of MetS components increased, the presence of NL was significantly higher in male subjects (P for trend < 0.001).

Insulin resistance (IR) has been known as a

Author contributions

Yang-ju Kim and Cheol-Hwan Kim participated in the conception and design of the study. Eun-Ju Sung and Ho-Cheol Shin performed the data collection. Yang-ju Kim, Seong-Rai Kim and Won-Ju Jung participated in data analysis and statistical analysis. Yang-ju Kim and Cheol-Hwan Kim wrote and critiqued drafts of the manuscript. Cheol-Hwan Kim supervised all of the processes involved in the present study. All authors read and approved the final manuscript.

Funding

There was no funding for this study.

Conflict of interest

The authors have no conflict ofinterest for this article and have no financial relationship with any organization.

References (24)

Cited by (0)

View full text