糖尿病及糖尿病前期患者上尿路结石成分的特点及其形成的影响因素分析
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摘要
目的探讨糖尿病及糖尿病前期患者上尿路结石成分的特点,并对结石成分进行相关的影响因素分析。方法回顾性分析2015年11月至2017年9月在大连医科大学附属第二医院诊治上尿路结石患者的临床资料,比较糖尿病(DM)及糖尿病前期患者(观察组)和非糖尿病患者(对照组)之间结石成分的差异,并通过多因素Logistic回归分析相关结石形成的影响因素。结果两组患者性别、体重指数(BMI)、血尿酸、尿液pH等资料比较差异无统计学意义(P>0.05),空腹血糖水平和年龄比较有统计学差异(P<0.05)。观察组尿酸结石的比例明显高于对照组(P<0.05),观察组感染性结石的比例明显低于对照组(P<0.05)。多因素Logistic回归分析显示糖尿病及糖尿病前期和尿液pH为尿酸结石和感染性结石形成的独立影响因素(P<0.05)。结论糖尿病及糖尿病前期患者较非糖尿病患者更容易患尿酸结石,非糖尿病患者较糖尿病及糖尿病前期患者更容易患感染性结石。糖尿病及糖尿病前期和尿液pH为尿酸结石和感染性结石形成的独立影响因素。
Objective To explore the characteristics of upper urinary tract stones in patients with diabetes and pre-diabetes,and to analyze the related factors affecting the stone components. Methods Retrospective analysis of clinical data of patients with upper urinary calculi diagnosed in the Second Affiliated Hospital of Dalian Medical University from November 2015 to September 2017 was performed to compare differences in stone composition between diabetic( DM)/pre-diabetic patients(observation group) and non-diabetic patients( control group). Then,the factors affecting the stone formation were analyzed by multivariate logistic regression. Results The clinical data of the two groups were compared and analyzed. There were no significant differences in gender,body mass index(BMI),blood uric acid and urine p H between the two groups(P>0.05),however significant differences were noticed in the fasting blood glucose level and age(P<0.05). The proportion of uric acid stones in the observation group was significantly higher than that in the control group(P<0.05). The proportion of infectious stones in the observation group was significantly lower than that in the control group(P<0.05). Multivariate logistic regression analysis revealed that diabetes/pre-diabetes and urine p H were independent factors affecting the formation of uric acid stones and infectious stones(P<0.05).Conclusion Patients with diabetes and pre-diabetes are more likely to develop uric acid stones than non-diabetic patients. Non-diabetic patients are more susceptible to infectious stones than diabetic and pre-diabetic patients. Diabetes/pre-diabetes and urine p H are independent factors affecting the formation of uric acid stones and infectious stones.
Objective To explore the characteristics of upper urinary tract stones in patients with diabetes and pre-diabetes,and to analyze the related factors affecting the stone components. Methods Retrospective analysis of clinical data of patients with upper urinary calculi diagnosed in the Second Affiliated Hospital of Dalian Medical University from November 2015 to September 2017 was performed to compare differences in stone composition between diabetic( DM)/pre-diabetic patients(observation group) and non-diabetic patients( control group). Then,the factors affecting the stone formation were analyzed by multivariate logistic regression. Results The clinical data of the two groups were compared and analyzed. There were no significant differences in gender,body mass index(BMI),blood uric acid and urine p H between the two groups(P>0.05),however significant differences were noticed in the fasting blood glucose level and age(P<0.05). The proportion of uric acid stones in the observation group was significantly higher than that in the control group(P<0.05). The proportion of infectious stones in the observation group was significantly lower than that in the control group(P<0.05). Multivariate logistic regression analysis revealed that diabetes/pre-diabetes and urine p H were independent factors affecting the formation of uric acid stones and infectious stones(P<0.05).Conclusion Patients with diabetes and pre-diabetes are more likely to develop uric acid stones than non-diabetic patients. Non-diabetic patients are more susceptible to infectious stones than diabetic and pre-diabetic patients. Diabetes/pre-diabetes and urine p H are independent factors affecting the formation of uric acid stones and infectious stones.
引文
[1] Sorokin I,Mamoulakis C,Miyazawa K,et al.Epidemiology of stone disease across the world[J].World J Urol,2017,35(9):1301-1320.
[2] Wang W,Fan J,Huang G,et al.Prevalence of kidney stones in mainland China:A systematic review[J].Sci Rep,2017,7:41630.
[3] Wild S,Roglic G,Green A,et al.Global prevalence of diabetes:estimates for the year 2000 and projections for 2030[J].Diabetes Care,2004,27(5):1047-1053.
[4] Pan WH,Yeh WT,Hwu CM,et al.Undiagnosed diabetes mellitus in Taiwanese subjects with impaired fasting glycemia:impact of female sex,central obesity,and short stature[J].Chin J Physiol,2001,44(1):44-51.
[5] Meydan N,Barutca S,Caliskan S,et al.Urinary stone disease in diabetes mellitus[J].Scand J Urol Nephrol,2003,37(1):64-70.
[6] Taylor EN,Stampfer MJ,Curhan GC.Diabetes mellitus and the risk of nephrolithiasis[J].Kidney Int,2005,68(3):1230-1235.
[7] Zeng G,Mai Z,Xia S,et al.Prevalence of kidney stones in China:an ultrasonography based cross-sectional study[J].BJU Int,2017,120(1):109-116.
[8] Akarken I,Tarhan H,Ekin RG,et al.Visceral obesity:A new risk factor for stone disease[J].Can Urol Assoc J,2015,9(11-12):E795-E799.
[9] Masterson JH,Woo JR,Chang DC,et al.Dyslipidemia is associated with an increased risk of nephrolithiasis[J].Urolithiasis,2015,43(1):49-53.
[10] Obligado SH,Goldfarb DS.The association of nephrolithiasis with hypertension and obesity:a review[J].Am J Hypertens,2008,21(3):257-264.
[11] Maalouf NM.Metabolic syndrome and the genesis of uric acid stones[J].J Ren Nutr,2011,21(1):128-131.
[12] 应焱燕,许国章.糖尿病前期的研究进展[J].实用预防医学,2016,23(2):250-253.
[13] Lieske JC,Pena de Lavega LS,Gettman MT,et al.Diabetes mellitus and the risk of urinary tract stones:a population based case-control study[J].Am J Kidney Dis,2006,48(6):897-904.
[14] Pak CY,Sakhaee K,Moe O,et al.Biochemical profile of stone-forming patients with diabetes mellitus[J].Urology,2003,61(3):523-527.
[15] Nerli R,Jali M,Guntaka AK,et al.Type 2 diabetes mellitus and renal stones[J].Adv Biomed Res,2015,4:180.
[16] Kadlec AO,Greco K,Fridirici ZC,et al.Metabolic syndrome and urinary stone composition:what factors matter most[J].Urology,2012,80(4):805-810.
[17] Alderman M,Redfern JS.Serum uric acid-a cardiovasular risk factor?[J].Ther Umsch,2004,61(9):547-552.
[18] Hess B.Metabolic syndrome,obesity and kidney stones[J].Arab J Urol,2012,10(3):258-264.
[19] Lingeman JE,Saywell RM,Woods JR,et al.Cost analysis of extracorporeal shock wave lithotripsy relative to other surgical and nonsurgical treatment alternatives for urolithiasis[J].Med Care,1986,24(12):1151-1160.
[20] Hedelin H.Uropathogens and urinary tract concretion formation and catheter encrustations[J].Int J Antimicrob Agents,2002,19(6):484-487.
[2] Wang W,Fan J,Huang G,et al.Prevalence of kidney stones in mainland China:A systematic review[J].Sci Rep,2017,7:41630.
[3] Wild S,Roglic G,Green A,et al.Global prevalence of diabetes:estimates for the year 2000 and projections for 2030[J].Diabetes Care,2004,27(5):1047-1053.
[4] Pan WH,Yeh WT,Hwu CM,et al.Undiagnosed diabetes mellitus in Taiwanese subjects with impaired fasting glycemia:impact of female sex,central obesity,and short stature[J].Chin J Physiol,2001,44(1):44-51.
[5] Meydan N,Barutca S,Caliskan S,et al.Urinary stone disease in diabetes mellitus[J].Scand J Urol Nephrol,2003,37(1):64-70.
[6] Taylor EN,Stampfer MJ,Curhan GC.Diabetes mellitus and the risk of nephrolithiasis[J].Kidney Int,2005,68(3):1230-1235.
[7] Zeng G,Mai Z,Xia S,et al.Prevalence of kidney stones in China:an ultrasonography based cross-sectional study[J].BJU Int,2017,120(1):109-116.
[8] Akarken I,Tarhan H,Ekin RG,et al.Visceral obesity:A new risk factor for stone disease[J].Can Urol Assoc J,2015,9(11-12):E795-E799.
[9] Masterson JH,Woo JR,Chang DC,et al.Dyslipidemia is associated with an increased risk of nephrolithiasis[J].Urolithiasis,2015,43(1):49-53.
[10] Obligado SH,Goldfarb DS.The association of nephrolithiasis with hypertension and obesity:a review[J].Am J Hypertens,2008,21(3):257-264.
[11] Maalouf NM.Metabolic syndrome and the genesis of uric acid stones[J].J Ren Nutr,2011,21(1):128-131.
[12] 应焱燕,许国章.糖尿病前期的研究进展[J].实用预防医学,2016,23(2):250-253.
[13] Lieske JC,Pena de Lavega LS,Gettman MT,et al.Diabetes mellitus and the risk of urinary tract stones:a population based case-control study[J].Am J Kidney Dis,2006,48(6):897-904.
[14] Pak CY,Sakhaee K,Moe O,et al.Biochemical profile of stone-forming patients with diabetes mellitus[J].Urology,2003,61(3):523-527.
[15] Nerli R,Jali M,Guntaka AK,et al.Type 2 diabetes mellitus and renal stones[J].Adv Biomed Res,2015,4:180.
[16] Kadlec AO,Greco K,Fridirici ZC,et al.Metabolic syndrome and urinary stone composition:what factors matter most[J].Urology,2012,80(4):805-810.
[17] Alderman M,Redfern JS.Serum uric acid-a cardiovasular risk factor?[J].Ther Umsch,2004,61(9):547-552.
[18] Hess B.Metabolic syndrome,obesity and kidney stones[J].Arab J Urol,2012,10(3):258-264.
[19] Lingeman JE,Saywell RM,Woods JR,et al.Cost analysis of extracorporeal shock wave lithotripsy relative to other surgical and nonsurgical treatment alternatives for urolithiasis[J].Med Care,1986,24(12):1151-1160.
[20] Hedelin H.Uropathogens and urinary tract concretion formation and catheter encrustations[J].Int J Antimicrob Agents,2002,19(6):484-487.
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