Clinical ScienceAssociation of nephrolithiasis with metabolic syndrome and its components
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.
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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.
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