Abstract

INTRODUCTION AND OBJECTIVES: Cumulative evidences indicate a tight association between urinary stone and dyslipidemia. Statins are widely used in clinical treatment of dyslipidemia. It is interesting and also important to know whether statin use can reduce the risk of upper urinary tract stone in patients with dyslipidemia. METHODS: We used data sourced from Longitudinal Health Insurance Database, which consists of one million randomly selected subjects from the National Health Insurance Research Database of Taiwan. Health Insurance System of Taiwan covers approximately 23 million people (98% of population). From 1997 to 2001, a total of 11785 subjects, 5926 males and 5859 females, with age 18-year-old or older were identified as dyslipidemia. All subjects did not have previous diagnosis of urinary stone. A cohort of 23570 (2 for each subject with dyslipidemia) age and gender matched subjects without the diagnosis of dyslipidemia and urinary stone were enrolled as the control group. All subjects were followed up to the end of 2009 with a minimal follow-up of 8 years. Multi-variables, including statin use, hypertension, and diabetes mellitus (DM), were taken into account. A Cox proportional hazard regression model was used to calculate the risk of upper urinary tract stone in study and control groups. RESULTS: At the end of follow-up, 1817 (15.4%) of the 11785 dyslipidemia subjects and 2445 (10.4%) of the 23570 control subjects developed upper urinary tract stones. After adjusting for age, gender, hypertension and DM, dyslipidemia was associated with a significantly increased risk of urinary stone (hazard ratio 2.086, 95% confidence interval, 1.929 2.256, p< 0.0001). The dyslipidemia subjects were further stratified into statin user group and non-statin user group. Nine hundred and sixty eight (15.1%) of the 6401 statin users and 849 (15.8%) of the 5384non-statin users developedupper urinary tract stones.Dyslipidemia patients who received statin treatment were not less likely to develop upper urinary tract stone than the patients who never used statin (hazard ratio 1.074, 95% confidence interval, 0.976 1.181, p 1⁄4 0.1430). CONCLUSIONS: Dyslipidemia is an independent risk factor for upper urinary tract stone. The findings of this study suggest that the use of statin cannot reduce the risk of upper urinary tract stone in patients with dyslipidemia.

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