Correlation analysis between prognostic nutritional index and kidney stone risk: a database analysis based on the NHANES
-
摘要: 目的 肾结石是泌尿外科常见病，治疗后的复发率高达50%。据报道，结石的发病受营养状态的影响。因此，本文选择了美国国家健康与营养调查(NHANES)数据库研究预后营养指数(PNI)对肾结石发病的影响。方法 本研究利用2007—2018年的美国NHANES人群数据，首先进行了人群的筛选和数据提取。参考既往研究，将纳入人群根据PNI按照四分位法从小到大分为Q1~Q4四组。最后使用STATA软件进行单因素和多因素的回归分析。结果 研究共纳入了30265例研究对象，其中肾结石患者2889例，平均年龄(47.6±0.23)岁，平均PNI为(53.4±0.07)，男性比例48.8%，肥胖人群占29.5%。分析显示，以Q1为参考，Q4的单、多因素分析均显示肾结石发病风险显著降低(OR=0.65，95%CI：0.56~0.75，P < 0.001；OR=0.79，95%CI：0.67~0.94，P=0.007)。结论 较高的PNI指数和较低的肾结石发病相关。因此，维持良好的营养状态，特别是白蛋白的水平可能有利于预防结石的发生。Abstract: Objective Kidney stone is a common urinary disease, and its recurrence rate is still as high as 50% after treatment. The incidence of stones is reported to be affected by nutritious factors. Therefore, this article chose National Health and Nutrition Examination Survey (NHANES) database to study the predictive ability of prognostic nutritional index (PNI) for renal calculi.Methods In this study, the NHANES data of American participants from 2007 to 2018 were selected. Participants were screened and the data extraction were carried out. According to previous studies, the included population was divided into four groups according to PNI, and univariate and multivariate regression analysis were performed using STATA data analysis software.Results A total of 30265 partcipants were included in this study, including 2889 patients with renal calculi, with an average age of (47.6±0.23) years and an average PNI of (53.4±0.07). The proportion of males was 48.8%, and the proportion of obese people was 29.5%. Setting Q1 group as reference, Q4 group's univariate and multivariate analysis both showed significant reduction in the incidence of kidney stones (OR=0.65, 95%CI: 0.56-0.75, P < 0.001; OR=0.79, 95%CI: 0.67-0.94, P=0.007).Conclusion Higher PNI may be correlated with lower kidney stone risk, so maintaining good nutritional status especially the serum albumin level is helpful to prevent the occurrence of kidney stone disease.
-
-
表 1 纳入人群基线信息
例(%)，X±S 项目 总人群(30265例) Q1(8455例) Q2(7449例) Q3(6962例) Q4(7399例) PNI 53.4±0.07 47.5±0.04 51.8±0.01 54.7±0.01 59.8±0.14 肾结石 是 2889(9.5) 966(11.4) 717(9.6) 609(8.7) 597(8.1) 否 27376(90.5) 7489(88.6) 6732(90.4) 6353(91.3) 6802(91.9) 年龄/岁 47.7±0.23 54.7±0.34 49.0±0.32 45.5±0.30 41.4±0.27 性别 男 14821(49.0) 3598(42.6) 3405(45.7) 3558(51.1) 4260(57.6) 女 15444(51.0) 4857(57.4) 4044(54.3) 3404(48.9) 3139(42.4) 种族 墨西哥裔 4602(15.2) 1017(12.0) 1163(15.6) 1160(16.7) 1262(17.1) 其他拉丁裔 3202(10.6) 803(9.5) 845(11.3) 739(10.6) 815(11.0) 非拉丁裔白种人 12535(41.4) 3657(43.3) 3039(40.8) 2829(40.6) 3010(40.7) 非拉丁裔黑种人 6204(20.5) 2179(25.8) 1482(19.9) 1300(18.7) 1243(16.8) 包含混血的其他族裔 3722(12.3) 799(9.5) 920(12.4) 934(13.4) 1069(14.4) 教育水平 初中文化以下 3209(10.6) 902(10.7) 809(10.9) 718(10.3) 780(10.5) 高中肄业 4195(13.9) 1258(14.9) 940(12.6) 919(13.2) 1078(14.6) 高中毕业 6885(22.7) 1856(22.0) 1677(22.5) 1604(20.3) 1748(23.6) 大学肄业 8954(29.6) 2487(29.4) 2227(29.9) 2071(29.7) 2169(29.3) 大学毕业或以上 7022(23.2) 1952(23.1) 1796(24.1) 1650(23.7) 1624(21.9) BMI < 25 kg/m2 8642(28.6) 2152(25.5) 2068(27.8) 2174(31.2) 2248(30.4) ≥25 kg/m2 21623(71.4) 6303(74.5) 5381(72.2) 4788(68.8) 5151(69.6) 高血压 是 10983(36.3) 3841(45.4) 2726(36.6) 2224(31.9) 2192(29.6) 否 19282(63.7) 4614(54.6) 4723(63.4) 4738(68.1) 5207(70.4) 糖尿病 是 3992(13.2) 1547(18.3) 914(12.3) 761(10.9) 770(10.4) 否 25555(84.4) 6682(79.0) 6356(85.3) 6036(86.7) 6481(87.6) 边缘性 718(2.4) 226(2.7) 179(2.4) 165(2.4) 148(2.0) 吸烟100支烟以上 是 13385(44.2) 3738(44.2) 3160(42.4) 2986(42.9) 3501(47.3) 否 16880(55.8) 4717(55.8) 4289(57.6) 3976(57.1) 3898(52.7) 
下载: 导出CSV
-
[1] Wang W, Fan J, Huang G, et al. Prevalence of kidney stones in mainland China: A systematic review[J]. Sci Rep, 2017, 7: 41630. doi: 10.1038/srep41630
[2] Türk C, Petřík A, Sarica K, et al. EAU Guidelines on Interventional Treatment for Urolithiasis[J]. Eur Urol, 2016, 69(3): 475-482. doi: 10.1016/j.eururo.2015.07.041
[3] 周鹏, 顾月颖, 赵文超, 等. 经皮肾镜联合顺行输尿管软镜在输尿管结石中的应用[J]. 临床泌尿外科杂志, 2022, 37(3): 222-224, 228. https://lcmw.whuhzzs.com/article/doi/10.13201/j.issn.1001-1420.2022.03.014
[4] 沈宸, 范博, 李先承, 等. 输尿管软镜钬激光碎石术治疗肾下盏结石的有效性分析[J]. 临床泌尿外科杂志, 2021, 36(8): 622-626. https://www.cnki.com.cn/Article/CJFDTOTAL-LCMW202108007.htm
[5] 吴旭峰, 孙发. 肾结石发生机制及外科治疗研究[J]. 医学信息, 2021, 34(23): 25-28. https://www.cnki.com.cn/Article/CJFDTOTAL-YXXX202123008.htm
[6] Onodera T, Goseki N, Kosaki G. Prognostic nutritional index in gastrointestinal surgery of malnourished cancer patients[J]. Nihon Geka Gakkai Zasshi, 1984, 85(9): 1001-1005.
[7] 唐文超, 李远伟, 陈佳, 等. 术前预后营养指数及中性粒-淋巴细胞比值在非肌层浸润性膀胱癌患者复发中的预测价值[J]. 现代肿瘤医学, 2022, 30(12): 2218-2223. https://www.cnki.com.cn/Article/CJFDTOTAL-SXZL202212022.htm
[8] 潘晓涛, 马龙安, 赵金, 等. 术前预后营养指数在肝内胆管癌根治性切除术后的预后预测价值[J]. 现代肿瘤医学, 2022, 30(12): 2205-2209. https://www.cnki.com.cn/Article/CJFDTOTAL-SXZL202212019.htm
[9] 钱三祥, 薛刚, 路友群, 等. 预后营养指数对老年骨质疏松性椎体压缩骨折术后近期预后的影响[J]. 颈腰痛杂志, 2022, 43(2): 229-232. https://www.cnki.com.cn/Article/CJFDTOTAL-JYTZ202202021.htm
[10] Zhou J, Ma L, Zhao L, et al. Association Between the Prognostic Nutritional Index and Cognitive Function Among Older Adults in the United States: A Population-Based Study[J]. J Alzheimers Dis, 2021, 83(2): 819-831. doi: 10.3233/JAD-210141
[11] 郭晓娟, 田国祥, 潘振宇, 等. NHANES项目介绍及数据提取流程[J]. 中国循证心血管医学杂志, 2019, 11(6): 654-657. https://www.cnki.com.cn/Article/CJFDTOTAL-PZXX201906003.htm
[12] Zhang H, Lin Z, Chen J, et al. Association Between Dietary Fiber Intake and Heart Failure Among Adults: National Health and Nutrition Examination Survey 2009-2018[J]. Front Cardiovasc Med, 2022, 9: 893436. doi: 10.3389/fcvm.2022.893436
[13] Heslin KC, Alfier JM. Sexual Orientation Differences in Access to Care and Health Status, Behaviors, and Beliefs: Findings from the National Health and Nutrition Examination Survey, National Survey of Family Growth, and National Health Interview Survey[J]. Natl Health Stat Report, 2022, (171): 1-16.
[14] 刘如辉, 程宽, 郑芳芳, 等. 适度摄入锰有益于心血管健康: 基于美国NHANES 2011―2018年数据[J]. 山东第一医科大学(山东省医学科学院)学报, 2022, 43(4): 261-266. https://www.cnki.com.cn/Article/CJFDTOTAL-TSYX202204004.htm
[15] Nozoe T, Ninomiya M, Maeda T, et al. Prognostic nutritional index: a tool to predict the biological aggressiveness of gastric carcinoma[J]. Surg Today, 2010, 40(5): 440-443.
[16] 周悦玲, 丁峰. 肾结石的危险因素与诊断评估研究进展[J]. 上海交通大学学报(医学版), 2020, 40(5): 688-692. https://www.cnki.com.cn/Article/CJFDTOTAL-SHEY202005027.htm
[17] Zhao L, Zhao X, Tian P, et al. Prognostic utility of the prognostic nutritional index combined with serum sodium level in patients with heart failure[J]. Nutr Metab Cardiovasc Dis, 2022, 32(8): 1894-1902.
[18] Dong X, Wang B, Chen S, et al. Association between Prognostic Nutritional Index and Contrast-Associated Acute Kidney Injury in Patients Complicated with Chronic Kidney Disease and Coronary Artery Disease[J]. J Interv Cardiol, 2021, 2021: 2274430.
[19] Chang CW, Ke HL, Lee JI, et al. Metabolic Syndrome Increases the Risk of Kidney Stone Disease: A Cross-Sectional and Longitudinal Cohort Study[J]. J Pers Med, 2021, 11(11): 1154.
[20] Lee MR, Ke HL, Huang JC, et al. Obesity-related indices and its association with kidney stone disease: a cross-sectional and longitudinal cohort study[J]. Urolithiasis, 2022, 50(1): 55-63.
[21] Liu N, Feng Y, Li J, et al. Relationship between the dietary inflammatory index and kidney stone prevalence[J]. World J Urol, 2022, 40(6): 1545-1552.
[22] Asoudeh F, Talebi S, Jayedi A, et al. Associations of Total Protein or Animal Protein Intake and Animal Protein Sources with Risk of Kidney Stones: A Systematic Review and Dose-Response Meta-Analysis[J]. Adv Nutr, 2022, 13(3): 821-832.
[23] Moludi J, Tandorost A, Kamari N, et al. Dietary total antioxidant capacity and its association with renal function and kidney stones: Results of a RaNCD cohort study[J]. Food Sci Nutr, 2022, 10(5): 1442-1450.
[24] Jamshed A, Jabeen Q. Pharmacological Evaluation of Mentha piperita Against Urolithiasis: An In Vitro and In Vivo Study[J]. Dose Response, 2022, 20(1): 15593258211073087.
[25] Pinato DJ, North BV, Sharma R. A novel, externally validated inflammation-based prognostic algorithm in hepatocellular carcinoma: the prognostic nutritional index(PNI)[J]. Br J Cancer, 2012, 106(8): 1439-1445.
[26] Khan SR, Canales BK, Dominguez-Gutierrez PR. Randall's plaque and calcium oxalate stone formation: role for immunity and inflammation[J]. Nat Rev Nephrol, 2021, 17(6): 417-433.
[27] Wang K, Ge J, Han W, et al. Risk factors for kidney stone disease recurrence: a comprehensive meta-analysis[J]. BMC Urol, 2022, 22(1): 62.
[28] Zhu C, Huang D, Ma H, et al. High-Sensitive CRP Correlates With the Severity of Liver Steatosis and Fibrosis in Obese Patients With Metabolic Dysfunction Associated Fatty Liver Disease[J]. Front Endocrinol(Lausanne), 2022, 13: 848937.
[29] Ouldamer L, Jourdan ML, Pinault M, et al. Accumulation of Arachidonic Acid, Precursor of Pro-Inflammatory Eicosanoids, in Adipose Tissue of Obese Women: Association with Breast Cancer Aggressiveness Indicators[J]. Biomedicines, 2022, 10(5): 995.
-