An Evidence-based Medical Study Of The Association Between Metabolic Syndrome And Its Components And Urinary Calculi

【Background】Urological calculus is the most common and high incidence disease in the urology department,occupying the first place in the urology department inpatients.Both abroad and domestic in our country,the incidence of urinary calculi disease has been rising,while the overall incidence of urinary calculi incidence of 1% to 5% as compared with foreign significantly lower,but most studies have found that our country south of the Yangtze river region its incidence in the 5% to 10%,and even parts of our country such as guizhou and other places as high as 20%.In addition,diabetes is also a major systemic and overall metabolic system disease distributed in the world,and the number of diabetic patients in China is also the largest in the world.Diabetes is also an important component in MetS.With the continuous advancement of modernization,the improvement of the people’s livelihood and consumption level,as well as the constant changes in the rhythm,way of life and diet,the incidence of MetS is similar to DM.As time goes on,the incidence of MetS is also on the rise,and the rising trend is also extremely obvious.Metabolic syndrome(MetS)is currently defined as an accumulation of metabolic factors such as abnormal glucose metabolism,elevated blood pressure,abnormal blood lipids,etc.Metabolic syndrome is a syndrome of a series of closely complex metabolic and physiological changes.Recent definitions have included abdominal obesity,hypertension,abnormal glucose tolerance,or diagnosis of diabetes,and dyslipidemia.But both diabetes and the MetS,always have a literature study shows that diabetes,MetS are risk factors for urinary tract stones separately,but before the three to make a complete analysis of the evidence-based medical research is few and far between,or some less into literature,either some of the data is not complete,can’t make a definite conclusion.Therefore,we tried our best to collect literatures from all databases in both Chinese and foreign languages and conduct a complete sensitivity,bias,heterogeneity analysis and stratified analysis.To quantify the strength of the association between diabetes,MetS,and urinary calculi and to conduct a systematic review in conjunction with our studies.【Objective】Ever had many staff had diabetes or MetS with urinary calculi systematic review or meta-analysis,but always related personnel to collect and into literature is less,and we in this study,by as much as possible to collect all the foreign language,Chinese literature,read carefully and carefully the screen into each at the beginning of the paper,to respond to an entire network literature data comprehensive meta-analysis,So as to make an evidence-based medical study on the correlation between MetS and its components diabetes and urinary calculi with the most reliable and the most complete data.【Methods】In this paper,foreign language and Chinese databases were searched,and Wanfang,CNKI,Pub Med,Web of Science and Sinomed databases were searched by computer,with the time limit from 1841 to 2021.According to our inclusion and exclusion criteria,primary screening,re-screening and data extraction were conducted.Meta-analysis was performed using STATA16.0 software to evaluate the effects of metabolic syndrome component diabetes and metabolic syndrome on the incidence and recurrence of urinary calculi in the general population.At the same time,sensitivity analysis and stratification analysis were conducted to study the potential confounding effect.Finally,cumulative meta-analysis was performed to evaluate cumulative effect estimates over time.【Results】A total of 43 studies(35 cross-sectional studies and 8 cohort studies)were included.There were 41 studies on the correlation between glucose metabolism disorder and urinary calculi,and 16 literatures on the correlation between metabolic syndrome and urinary calculi.Meta-analysis combined with the results showed that the risk of diabetic urinary calculi was significantly higher than that of the control group(OR=1.37,95%CI:1.28～1.48,P < 0.01),the risk of urinary calculi with metabolic syndrome was significantly higher than that in the control group(OR=1.71,95%CI: 1.57～1.87,P < 0.01).As blood sugar rise,all studies showed that persistent poor blood glucose control,especially in men,the incidence of urinary calculi also increases,we combined into literature,made visible to the gender stratification analysis,such as male + female diabetes urinary calculi significantly increased risk(OR=1.39,95% CI: 1.27～1.53,P < 0.05).Male population(OR=1.27,95%CI: 1.11～1.46,P=0.07).In the female population(OR=1.45,95%CI: 1.18～1.77,P < 0.05).In the case of metabolic syndrome,the risk of urinary calculi in male + female patients with metabolic syndrome was significantly increased in gender stratification analysis(OR=1.70,95%CI:1.55～1.85,P < 0.05).Male population(OR=1.69,95%CI:1.09 ～2.62,P < 0.05).Female population(OR=1.39,95%CI: 0.61～3.13,P < 0.05).Metabolic syndrome was found to be gender-related,with a significantly higher risk in men than in women.Similarly,many studies included in our study have also shown that the occurrence of urinary calculi also affects the occurrence and development of diabetes.In addition,our stratified analysis also showed that,regardless of stratification by region OR ethnicity,the risk of diabetes and metabolic syndrome urinary calculi in western countries was significantly higher than that in China.If stratified by region,the risk of diabetes urinary calculi in Asian population was(OR =1.31,95% CI:1.23～ 1.40,P<0.05).Europeanpopulation(OR=1.48,95%CI:1.20～1.82,P < 0.05),American population(OR=1.44,95%CI:1.12～1.86,P < 0.05).A subgroup analysis for race and skin color was performed in the yellow population(OR=1.31,95%CI: 1.23～1.40,P < 0.05).Caucasians(OR=1.46,95%CI: 1.24～1.73,P < 0.05).In metabolic syndrome,the Asian population(OR=1.57,95%CI:1.49～1.65,P=0.24).Euroeapopulation(OR=1.83,95%CI:1.15～2.91,P=0.12).American population(OR=2.30,95%CI:1.99～2.67,P=0.96).A subgroup analysis for race and skin color was performed in the yellow population(OR=1.57,95%CI:1.49～1.65,P=0.24).Caucasians(OR=2.19,95%CI: 1.89～2.55,P=0.33).The risk was significantly higher in the foreign population than in the Asian population.Similarly,the gender-stratified analysis of our studies also showed that the risk of urinary stones in women with diabetes and metabolic syndrome was significantly lower than that in men.【Conclusions】Our study showed that whether it was MetS or MetS component diabetes,it was significantly related to the age,gender and location of urinary calculi.The meta-analysis also showed that the risk of urinary calculi in MetS and diabetic patients was significantly higher than that in normal people.It also shows that the prevention and active treatment of diabetes,MetS can have a preventive effect on urinary stone disease.