Association between serum lipid and nephrolithiasis based on the NHANES database

doi:10.3877/cma.j.issn.1674-3253.2024.05.011

Abstract

Abstract:

Objective

To conduct a cross-sectional study based on the National Health and Nutrition Examination Survey (NHANES) database in the United States to analyze the relationship between serum lipids and kidney stones.

Methods

7 154 participants were selected from the NHANES database from 2007 to 2016. Univariate and multivariate Logistic regression models and restricted cubic spline plots were used to analyze the correlation between serum lipids (high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglyceride, total cholesterol, cholesterol /high-density lipoprotein cholesterol) and the risk of kidney stones.

Results

The relationship between high-density lipoprotein cholesterol and kidney stones was non-linear, and the incidence of kidney stones decreased with the increase of high-density lipoprotein cholesterol. The relationship between low-density lipoprotein cholesterol, triglyceride, total cholesterol and cholesterol /high-density lipoprotein cholesterol and kidney stones were linear, and the risk of kidney stones increased with the increase of low-density lipoprotein cholesterol, triglyceride, total cholesterol and cholesterol/high-density lipoprotein cholesterol.

Conclusions

Low high-density lipoprotein cholesterol, high low-density lipoprotein cholesterol, hypertriglyceridemia, hypercholesterolemia, and high cholesterol/high-density lipoprotein cholesterol are associated with the incidence of kidney stones. The optimal management of dyslipidemia may reduce the risk of kidney stones.

Key words: Serum lipid, Kidney stones, National Health and Nutrition Examination Survey database, High-density lipoprotein cholesterol, Low-density lipoprotein cholesterol, Cholesterol, Triglyceride, A cross-sectional study

Mingchi Wang, Leqi Liang, Yongda Liu. Association between serum lipid and nephrolithiasis based on the NHANES database[J]. Chinese Journal of Endourology(Electronic Edition), 2024, 18(05): 485-490.

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References 27

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基线特征	无肾结石	肾结石患者	统计值	P值
例数	6 412	742
年龄[岁，(±s)]	53±15	57±15	t=-6.068	<0.001
性别[例(%)]			χ²=10.787	0.001
男	3 415(53.26)	348(46.90)
女	2 997(46.74)	394(53.10)
BMI[例(%)]			χ²=52.350	<0.001
≤20 kg/m²	248(3.87)	12(1.62)
>20且≤25 kg/m²	1 572(24.52)	134(18.06)
>25且≤30 kg/m²	2 268(35.37)	233(31.40)
>30 kg/m²	2 324(36.24)	363(48.92)
种族[例(%)]			χ²=56.657	<0.001
墨西哥裔美国人	920(14.35)	104(14.02)
非西班牙裔黑人	1 287(20.07)	82(11.05)
非西班牙裔白人	2 920(45.54)	417(56.20)
其他西班牙裔人	641(10.00)	91(12.26)
其他种族	644(10.04)	48(6.47)
高血压[例(%)]			χ²=39.281	<0.001
是	2 527(39.41)	381(51.35)
否	3 885(60.59)	361(48.65)
糖尿病[例(%)]			χ²=45.007	<0.001
是	818(12.76)	161(21.70)
否	5 594(87.24)	581(78.30)
冠心病[例(%)]			χ²=15.157	<0.001
是	260(4.05)	53(7.14)
否	6 152(95.95)	689(92.86)
饮酒[例(%)]			χ²=16.609	<0.001
从不饮酒者	2 116(33.00)	247(33.29)
轻到中度饮酒者	658(10.26)	111(14.96)
重度饮酒者	3 638(56.74)	384(51.75)
吸烟史[例(%)]			χ²=1.822	0.402
从不吸烟者	3 567(55.63)	411(55.39)
过去吸烟者	1 618(25.23)	201(27.09)
现在吸烟者	1 227(19.14)	130(17.52)
教育水平[例(%)]			χ²=0.497	0.505
>高中	3 473(54.16)	412(55.53)
≤高中	2 939(45.84)	330(44.47)
家庭收入贫困比[例(%)]			χ²=1.874	0.392
<1.3	1 827(28.49)	213(28.71)
≥1.3且<3.5	2 396(37.37)	293(39.49)
≥3.5	2 189(34.14)	236(31.81)
白蛋白[mg/L，M(Q₁，Q₃)]	8.0(4.3，16.2)	10.6(5.7，22.6)	Z=-6.626	<0.001
血肌酐(mg/dL)	120±73	125±69	t=-1.733	0.067
空腹血糖(mg/dL)	109±35	116±40	t=-4.449	<0.001
血脂水平
HDL-C(mg/dL)	56±17	52±16	t=5.888	<0.001
LDL-C(mg/dL)	113±34	117±35	t=2.725	0.006
甘油三酯(mg/dL)	120±65	131±70	t=-4.180	<0.001
总胆固醇(mg/dL)	191±40	197±40	t=3.349	<0.001
胆固醇/HDL-C	3.8±1.3	3.96±1.3	t=-3.384	<0.001

基线特征	无肾结石	肾结石患者	统计值	P值
例数	6 412	742
年龄[岁，(±s)]	53±15	57±15	t=-6.068	<0.001
性别[例(%)]			χ²=10.787	0.001
男	3 415(53.26)	348(46.90)
女	2 997(46.74)	394(53.10)
BMI[例(%)]			χ²=52.350	<0.001
≤20 kg/m²	248(3.87)	12(1.62)
>20且≤25 kg/m²	1 572(24.52)	134(18.06)
>25且≤30 kg/m²	2 268(35.37)	233(31.40)
>30 kg/m²	2 324(36.24)	363(48.92)
种族[例(%)]			χ²=56.657	<0.001
墨西哥裔美国人	920(14.35)	104(14.02)
非西班牙裔黑人	1 287(20.07)	82(11.05)
非西班牙裔白人	2 920(45.54)	417(56.20)
其他西班牙裔人	641(10.00)	91(12.26)
其他种族	644(10.04)	48(6.47)
高血压[例(%)]			χ²=39.281	<0.001
是	2 527(39.41)	381(51.35)
否	3 885(60.59)	361(48.65)
糖尿病[例(%)]			χ²=45.007	<0.001
是	818(12.76)	161(21.70)
否	5 594(87.24)	581(78.30)
冠心病[例(%)]			χ²=15.157	<0.001
是	260(4.05)	53(7.14)
否	6 152(95.95)	689(92.86)
饮酒[例(%)]			χ²=16.609	<0.001
从不饮酒者	2 116(33.00)	247(33.29)
轻到中度饮酒者	658(10.26)	111(14.96)
重度饮酒者	3 638(56.74)	384(51.75)
吸烟史[例(%)]			χ²=1.822	0.402
从不吸烟者	3 567(55.63)	411(55.39)
过去吸烟者	1 618(25.23)	201(27.09)
现在吸烟者	1 227(19.14)	130(17.52)
教育水平[例(%)]			χ²=0.497	0.505
>高中	3 473(54.16)	412(55.53)
≤高中	2 939(45.84)	330(44.47)
家庭收入贫困比[例(%)]			χ²=1.874	0.392
<1.3	1 827(28.49)	213(28.71)
≥1.3且<3.5	2 396(37.37)	293(39.49)
≥3.5	2 189(34.14)	236(31.81)
白蛋白[mg/L，M(Q₁，Q₃)]	8.0(4.3，16.2)	10.6(5.7，22.6)	Z=-6.626	<0.001
血肌酐(mg/dL)	120±73	125±69	t=-1.733	0.067
空腹血糖(mg/dL)	109±35	116±40	t=-4.449	<0.001
血脂水平
HDL-C(mg/dL)	56±17	52±16	t=5.888	<0.001
LDL-C(mg/dL)	113±34	117±35	t=2.725	0.006
甘油三酯(mg/dL)	120±65	131±70	t=-4.180	<0.001
总胆固醇(mg/dL)	191±40	197±40	t=3.349	<0.001
胆固醇/HDL-C	3.8±1.3	3.96±1.3	t=-3.384	<0.001

脂质分布的四分位数	模型1		模型2		模型3
脂质分布的四分位数	OR（95%CI）	P值	OR（95%CI）	P值	OR（95%CI）	P值
HDL-C(mg/dL)
Quantile 1	1.00(Reference)		1.00(Reference)		1.00(Reference)
Quantile 2	0.75(0.62～0.92)	0.006	0.78(0.62～0.99)	0.046	0.84(0.66～1.07)	0.152
Quantile 3	0.64(0.52～0.79)	<0.001	0.69(0.51～ 0.95)	0.022	0.79(0.57～1.08)	0.140
Quantile 4	0.54(0.43～0.67)	<0.001	0.60(0.39～0.93)	0.021	0.76(0.49～1.16)	0.205
LDL-C(mg/dL)
Quantile 1	1.00(Reference)		1.00 (Reference)		1.00(Reference)
Quantile 2	0.94(0.76～1.16)	0.566	1.01(0.76～1.33)	0.970	1.11(0.83～1.48)	0.482
Quantile 3	0.86(0.70～1.07)	0.179	0.97(0.66～1.43)	0.877	1.07(0.72～1.59)	0.738
Quantile 4	0.82(0.66～1.01)	0.066	0.88(0.52～1.47)	0.620	0.98(0.58～1.66)	0.937
甘油三酯(mg/dL)
Quantile 1	1.00(Reference)		1.00 (Reference)		1.00 (Reference)
Quantile 2	0.95(0.75～1.19)	0.627	0.80(0.63～1.02)	0.068	0.76(0.60～0.97)	0.029
Quantile 3	1.12(0.90～1.40)	0.293	0.85(0.66～1.10)	0.220	0.77(0.59～0.99)	0.049
Quantile 4	1.45(1.17～1.79)	<0.001	1.03(0.76～1.39)	0.865	0.89(0.66～1.21)	0.467
总胆固醇(mg/dL)
Quantile 1	1.00(Reference)		1.00 (Reference)		1.00(Reference)
Quantile 2	0.88(0.71～1.08)	0.214	0.94(0.71～1.25)	0.682	0.96(0.72～1.28)	0.780
Quantile 3	0.75(0.60～0.93)	0.009	0.85(0.57～1.25)	0.402	0.87(0.59～1.30)	0.504
Quantile 4	0.80(0.64～0.98)	0.035	0.96(0.57～1.59)	0.866	1.02(0.61～1.71)	0.937
胆固醇/HDL-C比
Quantile 1	1.00(Reference)		1.00 (Reference)		1.00(Reference)
Quantile 2	1.29(1.03～1.61)	0.028	1.21(0.91～1.62)	0.186	1.17(0.88～1.56)	0.283
Quantile 3	1.35(1.08～1.69)	0.009	1.15(0.78～1.69)	0.474	1.11(0.75～1.62)	0.602
Quantile 4	1.48(1.19～1.85)	<0.001	1.10(0.66～1.83)	0.722	1.07(0.64～1.78)	0.803

脂质分布的四分位数	模型1		模型2		模型3
脂质分布的四分位数	OR（95%CI）	P值	OR（95%CI）	P值	OR（95%CI）	P值
HDL-C(mg/dL)
Quantile 1	1.00(Reference)		1.00(Reference)		1.00(Reference)
Quantile 2	0.75(0.62～0.92)	0.006	0.78(0.62～0.99)	0.046	0.84(0.66～1.07)	0.152
Quantile 3	0.64(0.52～0.79)	<0.001	0.69(0.51～ 0.95)	0.022	0.79(0.57～1.08)	0.140
Quantile 4	0.54(0.43～0.67)	<0.001	0.60(0.39～0.93)	0.021	0.76(0.49～1.16)	0.205
LDL-C(mg/dL)
Quantile 1	1.00(Reference)		1.00 (Reference)		1.00(Reference)
Quantile 2	0.94(0.76～1.16)	0.566	1.01(0.76～1.33)	0.970	1.11(0.83～1.48)	0.482
Quantile 3	0.86(0.70～1.07)	0.179	0.97(0.66～1.43)	0.877	1.07(0.72～1.59)	0.738
Quantile 4	0.82(0.66～1.01)	0.066	0.88(0.52～1.47)	0.620	0.98(0.58～1.66)	0.937
甘油三酯(mg/dL)
Quantile 1	1.00(Reference)		1.00 (Reference)		1.00 (Reference)
Quantile 2	0.95(0.75～1.19)	0.627	0.80(0.63～1.02)	0.068	0.76(0.60～0.97)	0.029
Quantile 3	1.12(0.90～1.40)	0.293	0.85(0.66～1.10)	0.220	0.77(0.59～0.99)	0.049
Quantile 4	1.45(1.17～1.79)	<0.001	1.03(0.76～1.39)	0.865	0.89(0.66～1.21)	0.467
总胆固醇(mg/dL)
Quantile 1	1.00(Reference)		1.00 (Reference)		1.00(Reference)
Quantile 2	0.88(0.71～1.08)	0.214	0.94(0.71～1.25)	0.682	0.96(0.72～1.28)	0.780
Quantile 3	0.75(0.60～0.93)	0.009	0.85(0.57～1.25)	0.402	0.87(0.59～1.30)	0.504
Quantile 4	0.80(0.64～0.98)	0.035	0.96(0.57～1.59)	0.866	1.02(0.61～1.71)	0.937
胆固醇/HDL-C比
Quantile 1	1.00(Reference)		1.00 (Reference)		1.00(Reference)
Quantile 2	1.29(1.03～1.61)	0.028	1.21(0.91～1.62)	0.186	1.17(0.88～1.56)	0.283
Quantile 3	1.35(1.08～1.69)	0.009	1.15(0.78～1.69)	0.474	1.11(0.75～1.62)	0.602
Quantile 4	1.48(1.19～1.85)	<0.001	1.10(0.66～1.83)	0.722	1.07(0.64～1.78)	0.803

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