Metabolic syndrome and the composition of urinary calculi: is there any relation?

Abstract

IntroductionEpidemiologic studies demonstrate that obesity and diabetes increase the prevalence of urinary lithiasis. Most of these studies did not stratify the chemical composition of calculi and the physiological mechanisms responsible for this increased risk are not well understood. This study aims to investigate the relation between the metabolic syndrome and the composition of the urinary calculi.Material and methodsObservational and retrospective study of all urinary calculi analysis performed at the Centro Hospitalar do Tâmega e Sousa, Portugal – from January 2009 to September 2015. Calculi were analyzed by infrared spectroscopy.Results302 analyses of urinary calculi were identified. Metabolic syndrome was diagnosed in 20.5% of patients. A total of 7 different mineral compounds were identified: 51.6% (N = 156) contained calcium oxalate, 41% (N = 124) calcium phosphate, 37.7% (N = 114) uric acid, 22.1% (N = 67) ammonium urate, 9.6% (N = 29) ammonium magnesium phosphate, 6.3% (N = 19) sodium urate and 1.3% (N = 4) contained cystine. Patients with metabolic syndrome presented a higher proportion of uric acid calculi (66.1% vs. 0%, p <0.001) and ammonium urate calculi (38.7% vs. 17%, p = 0.001). Patients without metabolic syndrome had a higher proportion of calcium oxalate calculi (58.8% vs. 24.2%, p <0.001) and calcium phosphate (46.7% vs. 19.4%, p <0.001).ConclusionsThere is a statistically significant relation between metabolic syndrome and uric acid and ammonium urate calculi. Metabolic syndrome may be considered risk factor for this calculi and the diagnosis and treatment of this syndrome must be considered for urolithiasis prevention. Further studies are needed to better the understanding of physiological mechanisms underlying this relationship to improve our strategy of prevention of urinary lithiasis.

Optimization of urolithiasis treatment and diagnosis in the Turkestan region

“…Prescribing non-steroidal anti-inflammatory drugs is prioritized over opioids for relieving renal colic (does not induce vomiting) [ 4 ]. According to the results of randomized studies, the effectiveness of anticholinergics has not been proven [ 5 ]. With α-blockers, particularly tamsulosin, there is a decrease in pain and an improvement in the passing of stones and their fragments after extracorporeal shock wave and ureterorenoscopy lithotripsy [ 6 ].…”

“…An analysis of scientific publications indicates a significant prevalence of this pathology among the population and its negative consequences on health and quality of life [ 2 – 6 ]. According to the World Health Organization (WHO), genitourinary diseases affect people of any age, including young people under 40 [ 5 ]. These include abnormal development, traumatic injuries, neoplasms of the urinary and male genital tract, infectious and inflammatory diseases, urolithiasis, hydronephrosis, acute and chronic renal failure etc.…”

Quantification of Visceral Adipose Tissue (VAT) and Subcutaneous Adipose Tissue (SAT) Based on CT Scan Tissue Segmentation Associated with Urolithiasis Recurrence

“…VAT has a greater extent of metabolic activity when being compared to subcutaneous adipose tissue (SAT). A rise in metabolic activity may increase the likelihood of developing uric acid and ammonium urate calculi (11). Visceral adiposity syndrome can release free fatty acids (FFA) into the blood that can induce changes in insulin,which promote insulin resistance (a type of metabolic disease that can increase the possibility of urolithiasis) (12).…”