Sevgin TANER, Kamina PANAHLI, Asena ÜNAL, Gunay EKBERLİ, Orkun TOLUNAY

Üriner Sistem Taşı Olan Çocuklarda Obezitenin Metabolik Risk Faktörlerine Etkisi

Amaç: Hiperkalsiüri, hiperoksalüri, hiperürikozüri, hipositratüri üriner sistem taş hastalığına neden olan metabolik risk faktörleri olarak kabul edilmiştir. Obezitenin metabolik risk faktörlerine bağlı olarak taş oluşum riskini artırdığını bildiren birçok çalışma bulunmaktadır. Bu çalışmanın amacı metabolik risk faktörlerinin sıklığını ve vücut kitle indeksinin (VKİ) ile ilişkisini değerlendirmektir. Yöntem: 3 mm’nin üzerinde ürolitiazisi olan çocuklar çalışmaya dahil edildi. Demografik bilgiler ve idrar metabolik taramasını da içeren ve biyokimya analizleri kaydedildi. Bulgular: Ortalama yaşları 71±57 ay olan 155 hastanın (94 erkek/61 kadın) 98'inin (%63) ailesinde taş öyküsü vardı. Hastaların %38,7'sinde en az bir metabolik risk faktörü vardı ve en yaygın olanlar sırasıyla hiperoksalüri (%16,8) ve hipositratüriydi (%16,8). Taş boyutu ≥5 mm olan ve multipl taşı olan hastalarda metabolik risk faktörlerine daha sık rastlanmaktaydı (p=0,015, p=0,028). Hastalar, zayıf ve normal kilolu hastalar Grup 1 (n=99 hasta), fazla kilolu ve obez olanlar Grup 2 (n=56 hasta) olmak üzere gruplandırıldı. Hiperkalsiüri, hiperürikozüri, hiperoksalüri, hipositratüri ve sistinüri sıklıkları gruplar arasında benzer bulundu. Sonuç: Aile öyküsü üriner sistem taş hastalığında önemli bir uyarıcıdır. Taş boyutu >5 mm ve birden fazla taşı olan hastalarda metabolik risk faktörlerinin görülme olasılığı daha yüksek olduğundan, özellikle bu hastalarda bu açıdan değerlendirme yapılması uygun olacaktır. Bu çalışmada obezitenin metabolik risk faktörlerini arttırdığına dair bir bulguya rastlanmadı.

Anahtar Kelimeler:

ürolitiazis, obezite, vücut kitle indeksi, hiperoksalüri, hipositratüri

The Effect of Obesity on Metabolic Risk Factors in Children with Urinary Stones

Background: Hypercalciuria, hyperoxaluria, hyperuricosuria, hypocitraturia have accepted as metabolic risk factors causing urolithiasis. There are many studies reporting that obesity increases the risk of stone formation by metabolic risk factors. The aim of this study is to evaluate the frequency of metabolic risk factors and the effect of body mass index (BMI) on them. Methods: Children with urolithiasis >3 mm included in the study. Demographic information and biochemistry analyses including urine metabolic screening were recorded. Results: Of the 155 patients (94 male/61 female) included in the study, with a mean age of 71±57 months, 98 (63%) have a family history of stones. There was at least one metabolic risk factor in 38.7% of the patients, and the most common ones were hyperoxaluria (16.8%) and hypocitraturia (16.8%), respectively. The presence of metabolic risk factors was significantly higher in patients with stone size ≥5 mm and with multiple stones, respectively (p=0.015, p=0.028). Patients with underweight and normal weight were grouped as Group 1 (n=99 patients), and those with overweight and obese as Group 2 (n=56 patients). The frequencies of hypercalciuria, hyperuricosuria, hyperoxaluria, hypocitraturia and cystinuria were similar between groups. Conclusion: Family history is common in children with urinary system stones. Since the probability of metabolic risk factors is higher in patients with stone size >5 mm and multiple stones, evaluation in this regard would be appropriate, especially in these patients. There was no evidence in this study that obesity increases metabolic risk factors.

Keywords:

urolithiasis, obesity, body mass index, hyperoxaluria, hypocitraturia,

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