Dergiler / Türk Üroloji Dergisi/Turkish Journal of Urology / 2004 / Cilt: 30 - Sayı: 3
Vücut kitle indeksinin üriner sistem taş hastalığının metabolik değerlendirme sonuçlarına etkeisi var mıdır?
- Sayfa
- 360–365
- DOI
- —
Özet
Çalışmanın amacı üriner sistem taş hastalarını vücut kitle indekslerine göre normal ve normalden ağır olarak gruplandırarak taş hastalığına yol açabilecek risk faktörleri arasındaki farklılıkları karşılaştırmaktır. Yaş ortalamaları 44±14,85 (18-80) olan üriner sistem taş hastalığı tanısı almış 59 erkek ve 52 kadın hasta, normal kilolular (vücut kitle indeksi 0.05). 24 saatlik idrarı incelenmesi sonucunda, normal kilolu erkek hastalar ve fazla kilolu olanlara göre günlük ürik asit atılımları arasında fark saptandı (sırasıyla 0.29±0.21, 0.48±0.17, p=0.01). Ancak farka karşın hiperürikozürik hasta bulunmadığı için tek istatistiksel olarak anlamlı anomali idrar volümü olarak tespit edildi. Düşük idrar volümü, normal kilolu erkeklerde (13’e karşı 8, p=0.01) ve tüm grupta normal kilolularda (22’ye karşı 15, p=0.01) daha fazla görüldü. Bunun yanı sıra vücut kitle indeksi ve idrar volümü arasında, erkeklerde (r=0.286, p=0.03), kadınlarda (r=0.187, p=0.01) ve toplamda (r=0.222, p=0.02) zayıf da olsa istatistiksel olarak anlamlı bir korelasyon görüldü. Yapılan değerlendirme sonucunda fazla kilolu hastalarda taş hastalığını açısından riski arttıracak metabolik anomali farklılığı saptanmamıştır.
Abstract
Introduction: Obesity is a common health problem for developed countries and it is a growing problem in developing countries by changing dietary habits to energy-rich westernized diet. It is a risk factor for many diseases such as hypertension, hyperlipidemia, myocardial infarction and other cardiovascular diseases, hemorrhoids or varices, colelithiasis, arthritis and also for urolithiasis. We wanted to determine the difference in metabolic abnormalities, urine chemistries of the patients with urinary stone disease, when grouped as normal weight and overweight by using body mass index cut-off value, determined by World Health Organization. Materials and Methods: The metabolic analysis of 59 men and 52 women with urinary stone disease, aged 44±14.85 (18 to 80) years, were investigated for metabolic abnormalities that may cause urinary stone disease. The patients were divided into two groups by using the parameter body mass index, as normal weight patients (body mass index<25) and overweight patients (body mass index ≥25). For the metabolic evaluation of the urine 24 hours urine chemistry (density, pH, urine volume, calcium, oxalate, uric acid, citrate, sodium, potassium, chloride, phosphate, magnesium, and creatinine) and calcium oxalate super saturation index were analyzed. Calcium oxalate supersaturation index was also calculated by using the formula APCaOx = 1.9 x Calcium0.84 x Oksalate x Citrate-0.22 x Magnesium-0.12 x Volume-1.03 Metabolic abnormalities were defined as: low urine volume, hypercalciuria, hyperoxalosis, hyperuricosuria and hypocitraturia. Frequency of each metabolic abnormality and the urinary level of each metabolic constituent were compared for all patients and also for each sex. Results: Overweight patients were 59.3% (35) of the male group, 55.7% (29) of female group and 57.6% (64) of all patients. There was no difference in the stone episodes between normal and over weight stone formers (1.08±0.40 vs. 1.14±0.35, p=0.554 for males, 1.34±0.48 vs. 1.20±0.41, p=0.294 for females, respectively), nor in the number of the patients with metabolic abnormalities between normal and over weight stone formers (22 vs. 30 for males, 20 vs. 24 for females, respectively). There was no statistically significant difference in urine parameters and AP(CaOX), except the 24 hours urine uric acid levels the male normal weight and overweight stone formers (0.29±0.21 vs 0.48±0.10, respectively, p=0.01). However, there was no patient was found to be hyperuricosuric; so the only difference in the frequencies of metabolic abnormalities of the male, female and all normal and overweight patients was low urine volume. Low urine volume is higher in male and total normal weight patients (13 vs 8 in the male group respectively, p=0.01 and 22 vs 15 in all the all patients group, 0.01 respectively). Although it was weak, statistically significant correlation between body mass index and urine volume in the male (r=0.286, p=0.03), female (r=0.187, p=0.01) and all (r=0.222, p=0.02) patients. Conclusion: The increased incidence of stone disease in obese people was well documented, but the results of metabolic evaluation were conflicting. The cut-off values of the body mass index that were used to define the groups when comparing the metabolic analysis of the urinary stone disease in the previous studies, was very high. However, our study determined that there was no difference in the stone episodes and metabolic urine analysis of the patients with urinary stone disease, when they were grouped as normal weight patients and overweight patients by using body mass index.