上尿路结石患者体质指数对24h尿成分的影响

Impact o f body mass index on 24-hour urine composition in patients with upper urinary tract calculi

目的:探讨上尿路结石患者体质指数(body mass index,BMI)对24 h尿成分及相关血生化指标的影响。方法 :对119例上尿路结石患者进行代谢评估,根据BMI将其分为3组,正常组(18.5≤BMI<24.0,n=37)、超重组(24≤BMI<27,n=52)、肥胖组(27≤BMI,n=30),生化分析系统检测24 h尿钠、钾、钙、磷、尿酸、血钠、血钾、血钙、血磷、血尿酸、尿pH及尿比重等指标,比较组间各指标及代谢异常率的差异性。结果:男性中肥胖、超重组的24 h尿钠、钙、磷、尿酸及血尿酸均明显高于正常组(P<0.05);肥胖组尿pH明显低于超重组和正常组(P<0.05);超重组血磷高于正常组(P<0.05)。女性中肥胖组和超重组24 h尿钙、尿酸均明显高于正常组(P<0.05);肥胖组和超重组尿pH均明显低于正常组(P<0.05);肥胖组24 h尿钠高于正常组(P<0.05)。肥胖组高钠尿症、高钙尿症、高尿酸尿症及合并两种或两种以上代谢异常率明显高于正常组(P<0.05),超重组高钠尿症、高钙尿症及合并两种或两种以上代谢异常率明显高于正常组(P<0.05),而肥胖组的高钙尿症及合并两种或两种以上代谢异常率明显高于超重组(P<0.05)。结论:肥胖及超重对24 h尿成分及相关血生化、尿pH有一定影响,且存在性别差异,对结石病患者尤其是伴肥胖或超重者进行代谢评价是必要的。

Objective：To evaluate the effect of body mass index （BMI） on 24-hour urine compositions and blood biochemistries in Patients with upper urinary tract calculi. Methods：A total of 119 of patients with upper urinary tract calculi were evaluated ,and were classified as normal weight （18.5≤BMI〈24.0,n = 37）,overweight （24≤BMI〈27,n = 52）,or obese （27≤BMI,n = 30）. The 24- hour urine sodium,potassium,calcium,phosphate,uric acid, serum sodium,potassium,calcium,phosphate,uric acid,and urine pH, and urine specific gravity were determined by biochemistry analyzer and were compared among the three groups. The proportion of metabolic disturbances was also compared among the three groups. Results：In male patients with stones,24-hour urine sodium, calcium, phosphate, uric acid and serum uric acid in obese and overweight groups were both significantly higher than those in normal group （P 〈 0.05）. Urine pH in the obese group was significantly lower than that in overweight and normal groups （P 〈 0.05）. Serum phosphate level in the overweight group was significantly higher than that in the normal group （P 〈 0.05）. In female patients with stones, 24-hour urine calcium,uric acid in the obese and overweight groups were both significantly higher than those in the normal group （P 〈 0.05）. Urine pH in the obese and overweight groups were significantly lower than those in normal group（P 〈 0.05）. Urine sodium in the obese group was significantly higher than that in normal group （P 〈 0.05）. The proportion of hypersodiuria, hypercalciuria,hyperuricosuria and hyperphosphatemia and combined two or more metabolic disturbances in the obese group were significantly higher than those in normal group （P 〈 0.05）. The proportion of hypersodiuria,hypercalciuria and combined two or more metabolic disturbances in the overweight group were significantly higher than those in the normal group（P 〈 0.05）. The proportion of hypersodiuria and combined two or more metabolic disturbances in obese group were significantly higher than those in overweight group（P 〈 0.05）. Conclusion： Obesity and overweight play a role in changes in 24-hour compositions,associated blood bio- chemistries and urine pH, and there is gender difference. A metabolic evaluation is necessary for stone patients,especially for obese and overweight ones, in treating and preventing urinary stones.