Research On The Relationship Between Metabolic Syndrome And The Composition Of Complex Renal Calculi,Progression And Recurrence Of Kidney Stones

Objective:To investigate the effects of metabolic syndrome and its components on the development and recurrence of complex renal calculi and renal calculi.Methods : Patients with renal calculi were selected from Department of Urology in Sichuan Provincial People's Hospital during January 2015 to August 2016.370 patients with renal calculi were enrolled according to the inclusion and exclusion criteria.Firstly,158 patients with complex renal calculi were selected to study the effect of metabolic syndrome and its related metabolic factors on the size and components of the stones.Then,158 patients with complex renal calculi and 212 patients with uncomplicated renal calculi were divided into study group and control group,respectively,to analyze the relationship between metabolic factors related to metabolic syndrome and the progress of kidney stones.Finally,all 370 patients with renal calculi were followed up postoperatively for 6 months to analyze the relationship between metabolic syndrome and the recurrence of kidney stones.Results: A total of 370 patients with renal calculi were enrolled,including 158 patients with complex renal calculi and 212 patients with uncomplicated renal calculi.1? 158 patients with complex renal calculi were divided into 5 groups,according to whether the patients accompanied with metabolic syndrome or related metabolic abnormalities(BMI,blood pressure,blood glucose,blood lipid),respectively.The size of the stone and its components were compared among groups.Results showed that the diameters of stones in study groups with metabolic syndrome,hyperglycemia and hyperlipidemia are larger than those in control groups.About the stone components,higher proportion of six magnesium ammonium phosphate and uric acid stones were found in patients with metabolic syndrome;lower calcium oxalate monohydrate,higher carbonate apatite and six magnesium ammonium phosphate were found in hyperglycemia patients;and patients with high BMI ratio have higher proportion of uric acid calculi.2? There were statistical significant on BMI,fasting blood glucose and high density lipoprotein cholesterol content between groups of complex renal calculi patients and uncomplicated renal calculi(P<0.05).Multivariate Logistic regression analysis showed that BMI,fasting blood glucose and high density lipoprotein cholesterol were the independent predictors affecting the progress of renal calculi into complex renal calculi,such as the risk of complicated renal calculi increased 1.178 times and 1.889 times when BMI and fasting blood glucose increase per 1 unit,respectively,while the risk reduced 0.782 times when serum high density lipoprotein cholesterol increased per 10 units.3? After followed up 370 cases of renal calculi patients for 6 months,80 patients of recurrence were selected as the study group and 290 cases of no recurrence as control group.There were statistical significant on fasting blood glucose,blood triglyceride and high density lipoprotein cholesterol content between the two groups(P<0.05).Multivariate Logistic regression analysis showed that fasting blood glucose and high density lipoprotein cholesterol were independent predictors of recurrence of kidney stone.The risk of recurrence increased 1.819 times when the fasting blood glucose increase each unit;while the risk reduced 0.775 times when serum high density lipoprotein cholesterol increased per 10 unit.Conclusion:1? In patients with complex renal calculi,those accompanied with metabolic syndrome have larger diameter stone,higher proportion of six magnesium ammonium phosphate and uric acid stones than those without metabolic syndrome;those accompanied with hyperglycemia have larger diameter stone,lower proportion of calcium oxalate monohydrate,higher carbonate apatite and six magnesium ammonium phosphate than those with normal blood glucose level;those with hyperlipidemia have larger diameter than those with normal blood lipid level;those with increased BMI patients have higher proportion of uric acid in the stone than those with normal BMI.2? The increase of BMI and fasting blood glucose,the decrease of high density lipoprotein cholesterol level are independent predictors for the progress of kidney stones into complex renal calculi.3? The increase of fasting blood glucose and decrease of high density lipoprotein cholesterol level are risk factors of recurrence of kidney stone.