不同性别人体体脂成分与泌尿系结石的关系

The association between body fat composition and urinary stone disease in the different community-based sex populations

目的探讨社区人群中人体体脂成分与泌尿系结石(urinary stone disease,USD)在不同性别中的关系。方法本研究基于2014年3~5月北京平谷区横断面调查,选取其中1835名受试者。所有受试者均面访行问卷调查、人体学指标测量、留取血液标本并自愿留取24h标本测定血肌酐、血尿、电解质等。肾脏超声确定USD的诊断。人体成分分析采用生物电阻抗测试法、InBody720人体成分分析仪进行测定。分别在男性及女性中根据体脂率(body fat percentage,BFP)的三分位数分为体脂肪低、中、高三组。结果共纳入数据完整1730名受试者,年龄为(54.9±8.8)岁,男性占46.3%,超声证实的USD患病率为7.0%。在总体及男性受试者中结石的患病率随着BFP的升高显著升高(Ptrend<0.05)。男性发生结石风险为女性的2.63倍(95%CI 1.77~3.92)。男性受试者中,BFP的增加与USD患病率增加显著相关,多因素校正后高BFP组发生结石的风险是低BFP组的1.98倍(95%CI 1.07~3.69)。在女性受试者中未发现BFP与结石显著的相关性。结论普通社区男性人群中人体体脂比率的增加与USD形成风险相关,减重特别是降低体脂率可能有助于降低USD风险,但还需要进一步的研究明确。

Objective To investigate the association between body fat composition and urinary stone disease(USD)in different community-based sex populations.Methods The study was based on the cross-sectional survey performed in Pinggu District,Beijing in 2014.One thousand eight hundred and thirty-five participants in the survey were included in this study.All the subjects received interview for a questionnaire and somatological index measurement,and volunteered to take a 24-hour urine sample for determination of serum creatinine,blood urea,electrolytes and so on.Diagnosis of USD was identified by renal ultrasonic examination.The body composition analysis was performed with bioelectrical impedance measurement and a body composition analyzer(InBody720).Based on tertiles of the body fat percentage(BFP),the female and male subjects were divided into the low,medium and high body fat groups,respectively.Result In the present study,1730 participants were included in the final analysis.The mean age was 54.9±8.8 years,and 46.3%were males.The USD prevalence which ultrasonography proved was 7.0%.In all subjects and males,the prevalence of USD increased in parallel with BFP(P trend<0.05).The male had a odds ratio(OR)2.63 times that of the females(95%CI 1.77~3.92).In the male subjects,increase of BFP was significantly correlated with increase of the USD prevalence.In the multivariate logistic regression,the OR in the high BFP group was 1.98 times that in the low BFP group(95%CI 1.07~3.69),although there was no significant association between higher BFP and risk of USD in the female subjects.Conclusion In the male population in a common community,increase of BFP is associated with USD risk.Obesity measures,especially higher BFP,may help reduce USD risk,positively associated with a high risk of USD in males,but further studies are required to prove it.