The association of metabolic syndrome and urolithiasis.

Yee V Wong,Bhaskar K Somani,Paul Cook

doi:10.1155/2015/570674

Abstract

There has been an increasing prevalence of kidney stones over the last 2 decades worldwide. Many studies have indicated a possible association between metabolic syndrome and kidney stone disease, particularly in overweight and obese patients. Many different definitions of metabolic syndrome have been suggested by various organizations, although the definition by the International Diabetes Federation (IDF) is universally considered as the most acceptable definition. The IDF definition revolves around 4 core components: obesity, dyslipidemia, hypertension, and diabetes mellitus. Several hypotheses have been proposed to explain the pathophysiology of urolithiasis resulting from metabolic syndrome, amongst which are the insulin resistance and Randall's plaque hypothesis. Similarly the pathophysiology of calcium and uric acid stone formation has been investigated to determine a connection between the two conditions. Studies have found many factors contributing to urolithiasis in patients suffering from metabolic syndrome, out of which obesity, overweight, and sedentary lifestyles have been identified as major etiological factors. Primary and secondary prevention methods therefore tend to revolve mainly around lifestyle improvements, including dietary and other preventive measures.

Highlights

The prevalence of urolithiasis is increasing globally and is observed across sex, age, and race [1]
The new International Diabetes Federation (IDF) definition of metabolic syndrome differs from the other definitions in that it requires the evidence of central obesity defined by waist circumference (WC) with ethnicity specific threshold values and two or more of the other core components
The National Health and Nutrition Examination Survey (NHANES) 1999 to 2000 reported that participants who did not engage in any physical activity during leisure time had almost twice the odds of having metabolic syndrome with odds ratio of 1.90 and 95% confidence interval (CI) of 1.22 to 2.97 compared to those who were reportedly engaged in ≥150 minutes of physical activity each week. [45]

Summary

Introduction

The prevalence of urolithiasis is increasing globally and is observed across sex, age, and race [1]. With a rise in the incidence of stone disease and the surgical intervention for it, there is a significant cost to the patients and the economy. An increased incidence of urolithiasis of greater than 75% is seen in overweight and obese patients compared to their normal counterparts [4]. The increased incidence and prevalence of urolithiasis are in parallel with the rising incidence of metabolic syndrome. The latter leads to a rise of uric acid stones, increase in urinary phosphate and oxalate levels, and an overall rise in the ratio of stone disease in females. In USA, the treatment of urolithiasis caused by obesity and diabetes is estimated to cost 1.24 billion US dollars per year by the year of 2030 [4]. This review article will discuss the different definitions of metabolic syndrome, the proposed pathophysiology, the etiology, and the preventative measures for urolithiasis with metabolic syndrome

The Definition of Metabolic Syndrome

Proposed Pathophysiology of Urolithiasis in Metabolic Syndrome

Etiology of Urolithiasis in Metabolic Syndrome

Preventative Measures of Urolithiasis in Metabolic Syndrome

Findings

Conclusion