The association of body mass index and quantitative 24-h urine metabolites in patients with Nephrolithiasis: a systematic review and dose-response meta-analysis

Fatemah Taheri; Kurosh Djafarian; Cain Clark; Maryam Taheri; Farhang Djafari; Elaheh Honarkar-Shafie; Mohadeseh Aghasi; Sakineh Shab-Bidar

doi:10.1016/j.obmed.2020.100262

The association of body mass index and quantitative 24-h urine metabolites in patients with Nephrolithiasis: a systematic review and dose-response meta-analysis

Fatemah Taheri, Kurosh Djafarian, Cain Clark, Maryam Taheri, Farhang Djafari, Elaheh Honarkar-Shafie, Mohadeseh Aghasi, Sakineh Shab-Bidar

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Abstract

Objective The aim of the present study was to evaluate the impact of body mass index (BMI) on urinary excretion of different metabolites in patients with nephrolithiasis. Methods A systematic search of PubMed and Scopus was performed up to July 2019. The eligible studies based on inclusion/exclusion criteria were screened and their data were extracted. Finally, 91 articles were included for dose response analysis, of which, 14 articles were included. Patients were dichotomized according to their BMI, i.e. normal weight patients with BMI˂25 and overweight/obese patients with BMI≥25 kg/m². Results Our results indicated that normal weight stone forming patients excreted less calcium (p<0.001), uric acid (p<0.001), oxalate (p<0.001), sodium p<0.001), citrate (p<0.001) and magnesium (p<0.001), however, these patients also had a higher urinary pH (p<0.001). There was a linear dose-response relationship between BMI and 24-h excretion of oxalate (p linearity˂0.001), uric acid (p linearity ˂ 0.001), sodium (p linearity= 0.002), phosphate (p linearity = 0.006), citrate (p linearity = 0.003) and creatinine (p linearity=0.0006), respectively. Conclusion The findings from the present study highlight overweight and obesity increase the urinary excretion of both stone promoters (calcium, sodium, oxalate and uric acid) and inhibitors (citrate and magnesium) urinary pH and prevalence of kidney stones is still higher in overweight/obese patients. Overall, overweight and obese people have more chance to form the kidney stones.

Original language	English
Article number	100262
Number of pages	8
Journal	Obesity Medicine
Volume	20
Early online date	9 Aug 2020
DOIs	https://doi.org/10.1016/j.obmed.2020.100262
Publication status	Published - Dec 2020

Bibliographical note

NOTICE: this is the author’s version of a work that was accepted for publication in Obesity Medicine. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Obesity Medicine, 20, (2020) DOI: 10.1016/j.obmed.2020.100262

© 2020, Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/

Keywords

Acid uric
Body mass index
Obesity
Urinary calcium
Urolithiasis

ASJC Scopus subject areas

Internal Medicine
Endocrinology, Diabetes and Metabolism
Public Health, Environmental and Occupational Health

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.obmed.2020.100262

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title = "The association of body mass index and quantitative 24-h urine metabolites in patients with Nephrolithiasis: a systematic review and dose-response meta-analysis",

abstract = "Objective The aim of the present study was to evaluate the impact of body mass index (BMI) on urinary excretion of different metabolites in patients with nephrolithiasis. Methods A systematic search of PubMed and Scopus was performed up to July 2019. The eligible studies based on inclusion/exclusion criteria were screened and their data were extracted. Finally, 91 articles were included for dose response analysis, of which, 14 articles were included. Patients were dichotomized according to their BMI, i.e. normal weight patients with BMI˂25 and overweight/obese patients with BMI≥25 kg/m². Results Our results indicated that normal weight stone forming patients excreted less calcium (p<0.001), uric acid (p<0.001), oxalate (p<0.001), sodium p<0.001), citrate (p<0.001) and magnesium (p<0.001), however, these patients also had a higher urinary pH (p<0.001). There was a linear dose-response relationship between BMI and 24-h excretion of oxalate (p linearity˂0.001), uric acid (p linearity ˂ 0.001), sodium (p linearity= 0.002), phosphate (p linearity = 0.006), citrate (p linearity = 0.003) and creatinine (p linearity=0.0006), respectively. Conclusion The findings from the present study highlight overweight and obesity increase the urinary excretion of both stone promoters (calcium, sodium, oxalate and uric acid) and inhibitors (citrate and magnesium) urinary pH and prevalence of kidney stones is still higher in overweight/obese patients. Overall, overweight and obese people have more chance to form the kidney stones.",

keywords = "Acid uric, Body mass index, Obesity, Urinary calcium, Urolithiasis",

author = "Fatemah Taheri and Kurosh Djafarian and Cain Clark and Maryam Taheri and Farhang Djafari and Elaheh Honarkar-Shafie and Mohadeseh Aghasi and Sakineh Shab-Bidar",

note = "NOTICE: this is the author{\textquoteright}s version of a work that was accepted for publication in Obesity Medicine. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Obesity Medicine, 20, (2020) DOI: 10.1016/j.obmed.2020.100262 {\textcopyright} 2020, Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ ",

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language = "English",

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TY - JOUR

T1 - The association of body mass index and quantitative 24-h urine metabolites in patients with Nephrolithiasis

T2 - a systematic review and dose-response meta-analysis

AU - Taheri, Fatemah

AU - Djafarian, Kurosh

AU - Clark, Cain

AU - Taheri, Maryam

AU - Djafari, Farhang

AU - Honarkar-Shafie, Elaheh

AU - Aghasi, Mohadeseh

AU - Shab-Bidar, Sakineh

N1 - NOTICE: this is the author’s version of a work that was accepted for publication in Obesity Medicine. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Obesity Medicine, 20, (2020) DOI: 10.1016/j.obmed.2020.100262 © 2020, Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/

PY - 2020/12

Y1 - 2020/12

N2 - Objective The aim of the present study was to evaluate the impact of body mass index (BMI) on urinary excretion of different metabolites in patients with nephrolithiasis. Methods A systematic search of PubMed and Scopus was performed up to July 2019. The eligible studies based on inclusion/exclusion criteria were screened and their data were extracted. Finally, 91 articles were included for dose response analysis, of which, 14 articles were included. Patients were dichotomized according to their BMI, i.e. normal weight patients with BMI˂25 and overweight/obese patients with BMI≥25 kg/m². Results Our results indicated that normal weight stone forming patients excreted less calcium (p<0.001), uric acid (p<0.001), oxalate (p<0.001), sodium p<0.001), citrate (p<0.001) and magnesium (p<0.001), however, these patients also had a higher urinary pH (p<0.001). There was a linear dose-response relationship between BMI and 24-h excretion of oxalate (p linearity˂0.001), uric acid (p linearity ˂ 0.001), sodium (p linearity= 0.002), phosphate (p linearity = 0.006), citrate (p linearity = 0.003) and creatinine (p linearity=0.0006), respectively. Conclusion The findings from the present study highlight overweight and obesity increase the urinary excretion of both stone promoters (calcium, sodium, oxalate and uric acid) and inhibitors (citrate and magnesium) urinary pH and prevalence of kidney stones is still higher in overweight/obese patients. Overall, overweight and obese people have more chance to form the kidney stones.

AB - Objective The aim of the present study was to evaluate the impact of body mass index (BMI) on urinary excretion of different metabolites in patients with nephrolithiasis. Methods A systematic search of PubMed and Scopus was performed up to July 2019. The eligible studies based on inclusion/exclusion criteria were screened and their data were extracted. Finally, 91 articles were included for dose response analysis, of which, 14 articles were included. Patients were dichotomized according to their BMI, i.e. normal weight patients with BMI˂25 and overweight/obese patients with BMI≥25 kg/m². Results Our results indicated that normal weight stone forming patients excreted less calcium (p<0.001), uric acid (p<0.001), oxalate (p<0.001), sodium p<0.001), citrate (p<0.001) and magnesium (p<0.001), however, these patients also had a higher urinary pH (p<0.001). There was a linear dose-response relationship between BMI and 24-h excretion of oxalate (p linearity˂0.001), uric acid (p linearity ˂ 0.001), sodium (p linearity= 0.002), phosphate (p linearity = 0.006), citrate (p linearity = 0.003) and creatinine (p linearity=0.0006), respectively. Conclusion The findings from the present study highlight overweight and obesity increase the urinary excretion of both stone promoters (calcium, sodium, oxalate and uric acid) and inhibitors (citrate and magnesium) urinary pH and prevalence of kidney stones is still higher in overweight/obese patients. Overall, overweight and obese people have more chance to form the kidney stones.

KW - Acid uric

KW - Body mass index

KW - Obesity

KW - Urinary calcium

KW - Urolithiasis

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U2 - 10.1016/j.obmed.2020.100262

DO - 10.1016/j.obmed.2020.100262

M3 - Review article

SN - 2451-8476

VL - 20

JO - Obesity Medicine

JF - Obesity Medicine

M1 - 100262

ER -

The association of body mass index and quantitative 24-h urine metabolites in patients with Nephrolithiasis: a systematic review and dose-response meta-analysis

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

UN SDGs

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