Associations between BMI, serum uric acid, serum glucose, and blood pressure with urinary tract stone opacity
Background: Urolithiasis refers to formation of stone in the kidney, ureter, or bladder. Several studies showed metabolic abnormalities were common in urolithiasis patients. The aim of this study was to describe the association between body-mass-index (BMI), serum uric acid, serum glucose, and blood pressure toward stone opacity in urinary tract stone patients.
Methods: This study was done retrospectively by reviewing registry data of urinary tract stone patients that had undergone ESWL on January 2008 – December 2013 in Department of Urology Cipto Mangunkusumo Hospital. Data concerning body mass index, serum uric acid, serum glucose, blood pressure, and urinary tract stone opacity were recorded. Associations between body mass index, serum uric acid, serum glucose and blood pressure with urinary tract stone opacity were analyzed using chi-square test.
Results: There were 2,889 patients who underwent ESWL on January 2008 – December 2013. We analyzed 242 subjects with complete data. Mean age was ± 12.78 (48.02 years). Male-to-female ratio was 2.27:1. Mean BMI was ± 3.78 (29.91 kg/m2). High risk BMIs were found in 161 patients (66.52%). The proportion of radioopaque stone was 77.69% (188 patients). Twenty two patients (9.1%) had normal blood pressure. Patients with high serum uric acid were 34.30% (83 patients). We found a significant association between random serum glucose level and stone opacity (p < 0.05).
Conclusion: There is an association between random serum glucose level and stone opacity in urolithiasis patients. Hyperglycemia patients tend to have radiolucent stone, whereas normoglycemia patients tend to have radioopaque stone.
Amaro CR, Goldberg J, Damasio PC, Leitao VA, Turney B, Padovani CR, et al. An update on metabolic assessment in patients with urinary lithiasis. World J Urol. 2015. 33(1):125-9. http://dx.doi.org/10.1007/s00345-014-1271-z
Cho ST, Jung SI, Myung SC, Kim TH. Correlation of metabolic syndrome with urinary stone composition. Int J Urol. 2013;20(2):208-13. http://dx.doi.org/10.1111/j.1442-2042.2012.03131.x
Ahmad I, Pansota MS, Tariq M, Tabassum SA. Frequency of metabolic abnormalities in urinary stones patients. Park J Med Sci. 2013;29(6):1363-6. http://dx.doi.org/10.12669/pjms.296.4007
Freitas Junior CH, Mazzucchi E, Danilovic A, Brito AH, Srougi M. Metabolic assessment of elderly men with urolithiasis. Clinics (Sao Paulo). 2012;67(5):457-61. http://dx.doi.org/10.6061/clinics/2012(05)09
Pascual E, Perdiguero M. Gout, diuretics and the kidney. Ann Rheum Dis. 2006;65(8):981-2. http://dx.doi.org/10.1136/ard.2005.049023
Naseri M, Varasteh AR, Alamdaran SA. Metabolic factors associated with urinary calculi in children. Iran J Kidney Dis. 2010;4(1):32-8.
Strohmaier WL, Wrobel BM, Schubert G. Overweight, insulin resistance and blood pressure (parameters of the metabolic syndrome) in uric acid urolithiasis. Urol Res. 2012;40(2):171-5. http://dx.doi.org/10.1007/s00240-011-0403-9
Fernandez A, Fuller A, Al-Bareeq R, Nott L, Razvi H. A comparison of the metabolic profiles of diabetic and non-diabetic uric acid stone formers. Can Urol Assoc J. 2013;7(3-4):E190-2. http://dx.doi.org/10.5489/cuaj.820
Maalouf N. Approach to the Adult Kidney Stone Former. Clin Rev Bone Miner Metab. 2012;10(1):38-49. http://dx.doi.org/10.1007/s12018-011-9111-9
Khanna D, Fitzgerald JD, Khanna PP, Bae S, Singh MK, Neogi T, et al. 2012 American College of Rheumatology guidelines for management of gout. Part 1: systematic nonpharmacologic and pharmacologic therapeutic approaches to hyperuricemia. Arthritis care & research. 2012;64(10):1431-46. http://dx.doi.org/10.1002/acr.21772
Maalouf NM, Sakhaee K, Parks JH, Coe FL, Adams-Huet B, Pak CY. Association of urinary pH with body weight in nephrolithiasis. Kidnet Int. 2004;65(4):1422-5. http://dx.doi.org/10.1111/j.1523-1755.2004.00522.x
Mosli HA, Mosli HH, Kamal WK. Kidney stone composition in overweight and obese patients: a preliminary report. Res Rep Urol. 2013;5:11-5. http://dx.doi.org/10.2147/rru.s39581
James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). Jama. 2014;311(5):507-20. http://dx.doi.org/10.1001/jama.2013.284427
WHO Consultation Expert. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004;363(9403):157-63. http://dx.doi.org/10.1016/S0140-6736(03)15268-3
American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2008;33(Suppl1):S55-60. doi: 10.2337/dc10-S062
Uroweb.org [Internet]. Europe: European Association of Urology [update 2014; cited 2014 Dec 19. Available from: http://uroweb.org/wp-content/uploads/22-Urolithiasis_LR.pdf.
Naghii MR, Babaei M, Hedayati M. Androgens involvement in the pathogenesis of renal stones formation. PloS One. 2014;9(4):e93790. http://dx.doi.org/10.1371/journal.pone.0093790
Yagisawa T, Ito F, Osaka Y, Amano H, Kobayashi C, Toma H. The influence of sex hormones on renal osteopontin expression and urinary constituents in experimental urolithiasis. J Urol. 2001;166(3):1078-82. http://dx.doi.org/10.1016/S0022-5347(05)65925-3
Soundararajan P, Mahesh R, Ramesh T, Begum VH. Effect of Aerva lanata on calcium oxalate urolithiasis in rats. Indian J Exp Biol. 2006;44(12):981-6.
Fan J, Chandhoke PS, Grampsas SA. Role of sex hormones in experimental calcium oxalate nephrolithiasis. J Am Soc Nephrol. 1999;10 Suppl 14:S376-80.
Kato Y, Yamaguchi S, Kakizaki H, Yachiku S. Influence of estrus status on urinary chemical parameters related to urolithiasis. Urol Res. 2005;33(6):476-80. http://dx.doi.org/10.1007/s00240-005-0511-5
Shakhssalim N, Gilani KR, Parvin M, Torbati PM, Kashi AH, Azadvari M, et al. An assessment of parathyroid hormone, calcitonin, 1,25 (OH)2 vitamin D3, estradiol and testosterone in men with active calcium stone disease and evaluation of its biochemical risk factors. Urol Res. 2011;39(1):1-7. http://dx.doi.org/10.1007/s00240-010-0276-3
Kang HW, Seo SP, Kim WT, Kim YJ, Yun SJ, Lee SC, et al. Hypertriglyceridemia is associated with increased risk for stone recurrence in patients with urolithiasis. Urology. 2014;84(4):766-71. http://dx.doi.org/10.1016/j.urology.2014.06.013
Tang W, Fu Q, Zhang Q, Sun M, Gao Y, Liu X, et al. The association between serum uric acid and residual beta -cell function in type 2 diabetes. J Diabetes Res. 2014;2014:709691. http://dx.doi.org/10.1155/2014/709691
Miyake T, Kumagi T, Furukawa S, Hirooka M, Kawasaki K, Koizumi M, et al. Hyperuricemia is a risk factor for the onset of impaired fasting glucose in men with a high plasma glucose level: a community-based study. PloS One. 2014;9(9):e107882. http://dx.doi.org/10.1371/journal.pone.0107882
Bhole V, Choi JW, Kim SW, de Vera M, Choi H. Serum uric acid levels and the risk of type 2 diabetes: a prospective study. Am J Med. 2010;123(10):957-61. http://dx.doi.org/10.1016/j.amjmed.2010.03.027
Wang J, Qin T, Chen J, Li Y, Wang L, Huang H, et al. Hyperuricemia and risk of incident hypertension: a systematic review and meta-analysis of observational studies. PloS One. 2014;9(12):e114259. http://dx.doi.org/10.1371/journal.pone.0114259
Samimi A, Ramesh S, Turin TC, MacRae JM, Sarna MA, Reimer RA, et al. Serum uric acid level, blood pressure, and vascular angiotensin II responsiveness in healthy men and women. Physiol Rep. 2014;2(12) pii: e12235. http://dx.doi.org/10.14814/phy2.12235
Skolarikos A, Straub M, Knoll T, Sarica K, Seitz C, Petrik A, et al. Metabolic Evaluation and Recurrence Prevention for Urinary Stone Patients: EAU Guidelines. Eur Urol. 2015;67(4):750-63. http://dx.doi.org/10.1016/j.eururo.2014.10.029
Jeong JY, Doo SW, Yang WJ, Lee KW, Kim JM. Differences in Urinary Stone Composition according to Body Habitus. Korean J Urol. 2011;52(9):622-5. http://dx.doi.org/10.4111/kju.2011.52.9.622
Copyright (c) 2015 Ikhlas A. Bramono, Nur Rasyid, Ponco Birowo
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors who publish with Medical Journal of Indonesia agree to the following terms:
- Authors retain copyright and grant Medical Journal of Indonesia right of first publication with the work simultaneously licensed under a Creative Commons Attribution-NonCommercial License that allows others to remix, adapt, build upon the work non-commercially with an acknowledgment of the work’s authorship and initial publication in Medical Journal of Indonesia.
- Authors are permitted to copy and redistribute the journal's published version of the work non-commercially (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in Medical Journal of Indonesia.