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心血管-肾脏-代谢综合征各阶段与肾结石患病率的关联:基于2007-2020年美国国家健康与营养检查调查(NHANES)的人群分析

Association of cardiovascular-kidney-metabolic syndrome stages with kidney stone prevalence: a population-based analysis of NHANES 2007-2020.

作者信息

Lu Guoliang, Tian Jinjun, Shi Feng, Zhang Ding-Guo, Wang Dawei

机构信息

Department of Urology, Ruijin Hospital, Shanghai, China.

Department of Urology, Shanghai Pudong New Area people's Hospital, Shanghai, China.

出版信息

BMJ Open. 2025 May 16;15(5):e096533. doi: 10.1136/bmjopen-2024-096533.

Abstract

BACKGROUND

The prevalence of kidney stones (KSs) has been increasing globally, and their association with cardiovascular disease and metabolic syndrome suggests a shared underlying pathophysiology. However, the impact of different stages of cardiovascular-kidney-metabolic (CKM) syndrome on KS prevalence remains unclear.

OBJECTIVE

This study aimed to investigate the association between the stages of CKM syndrome and the prevalence of KS in a nationally representative sample of adults in the USA.

METHODS

A total of 15 568 participants aged ≥20 years were included in the National Health and Nutrition Examination Survey 2007-2020 fasting subsample. CKM syndrome stages (0-4) were defined based on the 2023 American Heart Association Presidential Advisory on CKM Health. The KS history was determined using self-reported data. Multivariable logistic regression models were used to assess the association between the CKM syndrome stage and KS prevalence.

RESULTS

Of the 15 568 participants, 1501 (9.64%) reported a history of KS. The KS prevalence increased progressively with advancing CKM stage, rising from 5.10% in stage 0 to 16.55% in stage 4 (p<0.001). In the fully adjusted model, the ORs for KS were 1.18 (95% CI 0.83-1.68) for stage 1, 1.72 (95% CI 1.28 to 2.32) for stage 2, 2.00 (95% CI 1.29 to 3.10) for stage 3 and 2.36 (95% CI 1.64 to 3.40) for stage 4, compared with stage 0 ( for trend <0.001). Stratified analyses revealed no significant interactions between age, sex, race/ethnicity or other subgroups.

CONCLUSION

This study demonstrated a significant stepwise increase in KS prevalence with the advancing stages of CKM syndrome. These findings highlight the importance of monitoring and managing CKM syndromes to mitigate the risks of KS.

摘要

背景

全球范围内肾结石(KS)的患病率一直在上升,其与心血管疾病和代谢综合征的关联表明存在共同的潜在病理生理学机制。然而,心血管-肾脏-代谢(CKM)综合征的不同阶段对KS患病率的影响仍不明确。

目的

本研究旨在调查美国全国代表性成年样本中CKM综合征各阶段与KS患病率之间的关联。

方法

2007-2020年美国国家健康与营养检查调查空腹子样本中纳入了总共15568名年龄≥20岁的参与者。CKM综合征阶段(0-4)根据2023年美国心脏协会关于CKM健康的主席咨询意见定义。KS病史通过自我报告数据确定。多变量逻辑回归模型用于评估CKM综合征阶段与KS患病率之间的关联。

结果

在15568名参与者中,1501人(9.64%)报告有KS病史。KS患病率随着CKM阶段的进展而逐渐增加,从0期的5.10%上升至4期的16.55%(p<0.001)。在完全调整模型中,与0期相比,1期KS的比值比(OR)为1.18(95%置信区间0.83-1.68),2期为1.72(95%置信区间1.28至2.32),3期为2.00(95%置信区间1.29至3.10),4期为2.36(95%置信区间1.64至3.40)(趋势p<0.001)。分层分析显示年龄、性别、种族/民族或其他亚组之间无显著交互作用。

结论

本研究表明,随着CKM综合征阶段的进展,KS患病率显著逐步增加。这些发现凸显了监测和管理CKM综合征以降低KS风险的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/07bd/12086886/aaa123e95c15/bmjopen-15-5-g001.jpg

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