Modern aspects of comorbidity of urological disease and metabolic syndrome
Keywords:urolithiasis, metabolic syndrome, obesity, mellitus diabetes, hyperuricemia, oxidative stress
Urinary stone disease (USD) is one of the most common urological diseases occurring mainly in people of working age. USD is associated with metabolic disorders, the causes of which include endogenous and exogenous factors. Metabolic syndrome (MS) is a “non-infectious epidemic” that manifests itself in diabetes, hypertension, atherosclerosis, and obesity. The bidirectionality of metabolic processes is an important factor of USD and MS.
Aim. The paper aims at reviewing modern literary sources regarding the determination of pathogenetic links between the comorbidity of USD and MS.
Results. Nephrolithiasis spreads and recurs simultaneously with obesity. A decrease in urine pH, which is the basis for the formation of urate stones, is associated with the presence of obesity, insulin resistance, and MS. Under such conditions, urine alkalinization is the main treatment for urolithiasis. The risk of stone formation increases when the body mass index is more than 30 kg/m2.
Among patients with insulin resistance, nephrolithiasis is more severe, and kidney stones occur more often. The relationship between the hypertensive component of MS and USD has been established. Disorders of lipid metabolism have a negative prognosis, causing physicochemical aberrations in urine and the development of nephrolithiasis. Hyperuricemia is related to both the ability of insulin to reduce uric acid clearance in the proximal renal tubules and insulin resistance.
The link between USD and chronic inflammation is based on an increase in the endogenous synthesis of oxalates from endogenous glycogenic amino acids, which leads to the development of hyperoxaluria in patients with MS. Clinical studies show the formation of kidney stones in conditions of oxidative stress, an association between stone formation and the development of MS, coronary heart disease, arterial hypertension, which is the result of common pathogenetic characteristics.
Conclusions. The comorbidity of USD and MS is a systemic disorder. Kidney stone formation is associated with a decrease in urine pH against the background of MS. Hyperuricemia is comorbid with insulin resistance, dyslipoproteinemia, arterial hypertension, and abdominal obesity. Systemic chronic inflammation, comorbid with obesity and USD, based on an increase in the endogenous synthesis of oxalates from endogenous glycogenic amino acids. Oxidative stress has a common pathogenetic link between stone formation and insulin resistance, atherosclerosis, hypertension, and obesity.
Vozianov, S. O., Sahalevych, A. I., Boiko, A. I., Haiseniuk, F. Z., Kohut, V. V., Dzhuran, B. V., & Sosnin, M. D. (2021). Suchasnyi pohliad na bezdrenazhnu perkutannu nefrolitotrypsiiu [A modern view on tubeless percutaneous nephrolithotomy]. Zaporozhye medical journal, 23(4), 575-582. [in Ukrainian]. https://doi.org/10.14739/2310-1210.2021.4.226895
Bachurin, H. V., & Kolomoiets, Yu. S. (2020). Rezultaty vykorystannia predyktoriv zapalennia u khvorykh na sechokamianu khvorobu [Results of application of predictors of inflammation in patients with urolithiasis]. Zdorov'e muzhchiny, (1), 71-74. [in Ukrainian].
Zaitsev, V. I. (2019). Konservatyvne likuvannia sechokamianoi khvoroby v Ukraini ochyma likariv: mify ta realnist [Conservative treatment of urolithiasis in Ukraine through the eyes of doctors: myths and reality]. Zdorov'e muzhchiny, (4), 79-82. [in Ukrainian].
Ingimarsson, J. P., Krambeck, A. E., & Pais, V. M., Jr (2016). Diagnosis and Management of Nephrolithiasis. The Surgical clinics of North America, 96(3), 517-532. https://doi.org/10.1016/j.suc.2016.02.008
Vozianov, S. O., Saidakova, N. O., & Startseva, L. M. (2013). Stan ta perspektyvy rozvytku urolohichnoi sluzhby v Ukraini [The state and perspectives for the development of the urologic service in Ukraine]. Urologiya, 17(3), 89-95. [in Ukrainian].
Mykhailovskam N. S., Kulynychm T. O., Shershnovam O. V., Bazunm Ye. I., Bocharnykovam I. S., Padafam V. E., Kolesnykovam A. O., & Hura Yu. V. (2020). Osoblyvosti klinichnoho ta metabolichnoho profiliu khvorykh na ishemichnu khvorobu sertsia, sho asociiovana z tsukrovym diabetom 2 typu (retrospektyvnyi analiz) [Peculiarities of clinical and metabolic profile of patients with coronary artery disease associated with type 2 diabetes mellitus (retrospective analysis)]. Pathologia, 17(2), 156-163. [in Ukrainian]. https://doi.org/10.14739/2310-1237.2020.2.212754
Kostecka M. (2014). Eating habits of preschool children and the risk of obesity, insulin resistance and metabolic syndrome in adults. Pakistan journal of medical sciences, 30(6), 1299-1303. https://doi.org/10.12669/pjms.306.5792
Carbone, A., Al Salhi, Y., Tasca, A., Palleschi, G., Fuschi, A., De Nunzio, C., Bozzini, G., Mazzaferro, S., & Pastore, A. L. (2018). Obesity and kidney stone disease: a systematic review. Minerva urologica e nefrologica = The Italian journal of urology and nephrology, 70(4), 393-400. https://doi.org/10.23736/S0393-2249.18.03113-2
Daudon, M., Lacour, B., & Jungers, P. (2006). Influence of body size on urinary stone composition in men and women. Urological research, 34(3), 193-199. https://doi.org/10.1007/s00240-006-0042-8
Stus, V. P., Moiseenko, N. N., Shevchenko, U. O., Lisitskaya, L. F., Guzman, S. T., & Panchenko, A. S. (2018). Primenenie fitoterapii v lechenii kamnei pochek nebolshikh razmerov [The use of phytotherapy in the treatment of small kidney stones]. Urologiya, 22(3), 58-64. [in Russian]. https://doi.org/10.26641/2307-5222.214.171.1248.143275
Besiroglu, H., Otunctemur, A., & Ozbek, E. (2015). The metabolic syndrome and urolithiasis: a systematic review and meta-analysis. Renal failure, 37(1), 1-6. https://doi.org/10.3109/0886022X.2014.976133
Liu, X. J., Wen, J. G., Wan, Y. D., Hu, B. W., Wang, Q. W., & Wang, Y. (2018). Role of silodosin as medical expulsive therapy in ureteral calculi: a meta-analysis of randomized controlled trials. Urolithiasis, 46(2), 211-218. https://doi.org/10.1007/s00240-017-0974-1
Türk, C., Petřík, A., Sarica, K., Seitz, C., Skolarikos, A., Straub, M., & Knoll, T. (2016). EAU Guidelines on Diagnosis and Conservative Management of Urolithiasis. European urology, 69(3), 468-474. https://doi.org/10.1016/j.eururo.2015.07.040
Solomchak, D. B., Kostitska, I. O., & Detsyk, O. Z. (2019). Analiz vzaiemozviazkiv klasteriv metabolichnoho syndromu, asotsiiovanykh iz porushenniam vodno-soliovoho homeostazu, sechokamianoiu khvoroboiu ta inshymy zakhvoriuvanniamy sechovydilnoi systemy [Analysis of the interrelations for clusters of metabolic syndrome associated with impaired water-salt homeostasis, urolithiasis and other diseases of the urinary]. Problemy endokrynnoi patolohii, (2), 52-59. [in Ukrainian]. https://doi.org/10.21856/j-PEP.2019.2.08
Penniston, K. L., & Nakada, S. Y. (2018). Updates in the Metabolic Management of Calcium Stones. Current urology reports, 19(6), 41. https://doi.org/10.1007/s11934-018-0791-2
Messiah, S. E., Vidot, D. C., Somarriba, G., Haney, K., Aytur, S., Natale, R. A., Brosco, J. P., & Arheart, K. L. (2015). Obesity and cardiometabolic disease risk factors among US adolescents with disabilities. World journal of diabetes, 6(1), 200-207. https://doi.org/10.4239/wjd.v6.i1.200
Türk, C., Petřík, A., Sarica, K., Seitz, C., Skolarikos, A., Straub, M., & Knoll, T. (2016). EAU Guidelines on Interventional Treatment for Urolithiasis. European urology, 69(3), 475-482. https://doi.org/10.1016/j.eururo.2015.07.041
Cho, S. T., Jung, S. I., Myung, S. C., & Kim, T. H. (2013). Correlation of metabolic syndrome with urinary stone composition. International journal of urology, 20(2), 208-213. https://doi.org/10.1111/j.1442-2042.2012.03131.x
Moran, C. P., & Courtney, A. E. (2016). Managing acute and chronic renal stone disease. The Practitioner, 260(1790), 17-20.
Batagello, C. A., Monga, M., & Miller, A. W. (2018). Calcium Oxalate Urolithiasis: A Case of Missing Microbes?. Journal of endourology, 32(11), 995-1005. https://doi.org/10.1089/end.2018.0294
Sakhaee, K., Maalouf, N. M., & Sinnott, B. (2012). Clinical review. Kidney stones 2012: pathogenesis, diagnosis, and management. The Journal of clinical endocrinology and metabolism, 97(6), 1847-1860. https://doi.org/10.1210/jc.2011-3492
Kim, M. J., Hopfer, H., & Mayr, M. (2016). Harnsäure, Nierenerkrankungen und Nephrolithiasis [Uric acid, kidney disease and nephrolithiasis]. Therapeutische Umschau. Revue therapeutique, 73(3), 159-165. [in German]. https://doi.org/10.1024/0040-5930/a000773
Sanchez-Lozada, L. G., Rodriguez-Iturbe, B., Kelley, E. E., Nakagawa, T., Madero, M., Feig, D. I., Borghi, C., Piani, F., Cara-Fuentes, G., Bjornstad, P., Lanaspa, M. A., & Johnson, R. J. (2020). Uric Acid and Hypertension: An Update With Recommendations. American journal of hypertension, 33(7), 583-594. https://doi.org/10.1093/ajh/hpaa044
Lee, S. J., Oh, B. K., & Sung, K. C. (2020). Uric acid and cardiometabolic diseases. Clinical hypertension, 26, 13. https://doi.org/10.1186/s40885-020-00146-y
Dichi, I., Breganó, J. W., Simão, A. N. C., & Cecchini, R. (2014). Role of Oxidative Stress in Chronic Diseases. CRC Press. https://doi.org/10.1201/b16653
Venturini, D., Simão, A. N., & Dichi, I. (2015). Advanced oxidation protein products are more related to metabolic syndrome components than biomarkers of lipid peroxidation. Nutrition research, 35(9), 759-765. https://doi.org/10.1016/j.nutres.2015.06.013
Morelli, N. R., Scavuzzi, B. M., Miglioranza, L. H. D. S., Lozovoy, M. A. B., Simão, A. N. C., & Dichi, I. (2018). Metabolic syndrome components are associated with oxidative stress in overweight and obese patients. Archives of endocrinology and metabolism, 62(3), 309-318. https://doi.org/10.20945/2359-3997000000036
Loperena, R., & Harrison, D. G. (2017). Oxidative Stress and Hypertensive Diseases. The Medical clinics of North America, 101(1), 169-193. https://doi.org/10.1016/j.mcna.2016.08.004
Chernenko, D. V., Chernenko, V. V., Zheltovska, N. I., & Savchuk, V. I. (2015). Faktory riska "idiopaticheskogo" kal'tsii-oksalatnogo nefrolitiaza i puti protivoretsidivnogo lecheniya [Risk factors for "idiopathic" oxalate urolithiasis and ways of antirecurrent treatment]. Zdorov'e muzhchiny, (2), 129-133. [in Russian].
Bigagli, E., & Lodovici, M. (2019). Circulating Oxidative Stress Biomarkers in Clinical Studies on Type 2 Diabetes and Its Complications. Oxidative medicine and cellular longevity, 2019, 5953685. https://doi.org/10.1155/2019/5953685
How to Cite
LicenseAuthors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access)