Correlation of Metabolic Syndrome With Urinary Stone Composition

Int J Urol. 2013 Feb;20(2):208-13. doi: 10.1111/j.1442-2042.2012.03131.x. Epub 2012 Sep 30.

Abstract

Objective: To determine the correlation between metabolic syndrome and the distribution of stone components in patients with urolithiasis.

Methods: Between January 2007 and December 2010, renal or ureteral stones were collected from 712 patients (432 males, 280 females) who underwent surgical intervention at three hospitals in South Korea. Metabolic syndrome was defined according to the latest definition of the International Diabetes Federation, using ethnicity- and sex-specific cut-off values for central obesity. Patients were assessed by factors used in metabolic syndrome. All urinary stones were analyzed using infrared spectrophotometry and categorized according to their main component.

Results: The patients' mean age was 55.9 years (range 19-93 years). Of the 712 patients, 347 (48.7%; 205 males, 142 females) had a diagnosis of metabolic syndrome. Calcium oxalate (71.5%), uric acid (15.3%), carbonate apatite (8.0%) and struvite (4.1%) calculi were found as the main stone components. Overall, the proportion of uric acid calculi was markedly higher in patients with rather than without metabolic syndrome (19.6 vs 11.2%; P=0.002). However, the proportion of calcium oxalate, carbonate apatite and struvite calculi did not differ between the two groups. The multivariable-adjusted odds ratio for uric acid calculi according to the metabolic syndrome components indicated that the presence of metabolic syndrome was associated with a 93% increased odds ratio of uric acid calculi compared with the absence of metabolic syndrome. Impaired fasting glucose and hypertriglyceridemia were independent risk factors for uric acid calculi.

Conclusions: Metabolic syndrome is associated with a significantly increased risk of uric acid calculi development, especially those with impaired fasting glucose and hypertriglyceridemia.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Body Mass Index
  • Calcium Oxalate / chemistry
  • Calcium Oxalate / metabolism
  • Case-Control Studies
  • Comorbidity
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Kidney Calculi / chemistry
  • Logistic Models
  • Male
  • Metabolic Syndrome / diagnosis
  • Metabolic Syndrome / epidemiology*
  • Metabolic Syndrome / therapy
  • Middle Aged
  • Multivariate Analysis
  • Odds Ratio
  • Reference Values
  • Republic of Korea
  • Retrospective Studies
  • Risk Assessment
  • Severity of Illness Index
  • Sex Distribution
  • Statistics, Nonparametric
  • Ureteral Calculi / chemistry
  • Uric Acid / chemistry
  • Uric Acid / metabolism
  • Urinary Calculi / chemistry*
  • Urinary Calculi / epidemiology*
  • Urinary Calculi / surgery
  • Urolithiasis / diagnosis
  • Urolithiasis / epidemiology
  • Urolithiasis / surgery
  • Young Adult

Substances

  • Calcium Oxalate
  • Uric Acid