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24-10-2011 | General practice | Article

Kidney stones linked to increased diabetes risk


Free abstract

MedWire News: The risk for diabetes mellitus (DM) is raised by a third in the 5 years that follow a diagnosis of urinary calculi, study findings indicate.

"There has been speculation that kidney stone formation and the development of DM may share common pathophysiological pathways," explain Herng-Ching Lin (Taipei Medical University, Taiwan) and colleagues.

"However, to date, population based, longitudinal studies regarding the risk of diabetes among patients with urolithiasis are lacking," they add.

Lin and team therefore used a national health insurance database to examine the relationship between a history of urinary calculi and the risk for DM in Taiwan.

A total of 23,569 adults with new diagnoses of urinary calculi between 2001 and 2003 were recruited together with 70,707 individuals without urinary calculi who were matched for age, gender, and date of enrollment into the database (controls). All participants were then followed-up for a period of 5 years.

During follow-up, significantly more patients in the urinary calculi group than in the control group were diagnosed with DM, at 2921 (12.4%) versus 6171 (8.7%).

Further analysis, censored for individuals who died during follow-up, and adjusted for patient monthly income, geographic location, urbanization level, hypertension, hyperlipidemia, and obesity, revealed that the risk for receiving a first diagnosis of DM during the 5-year follow-up was 1.32 times greater for patients with urinary calculi than for those in the control group.

The researchers explain that extracorporeal shock wave lithotripsy is the preferred treatment for patients with urinary calculi. However, the development of DM is a potential consequence of this treatment, and could be a result of damage to pancreatic islet cells, they suggest in the Journal of Urology.

Another potential reason for the association between the two conditions could be that a common metabolic disorder is involved in the pathophysiology of DM and urinary calculi development.

"Furthermore, insulin resistance and compensatory hyperinsulinemia, which occur before DM is diagnosed, could result in increased susceptibility to UC [urinary calculi]," Lin and co-authors remark.

The team says that "the current data support further research into the role of insulin resistance in the pathogenesis of urolithiasis and the underlying mechanisms at work."

"Adequate lifestyle modifications and aggressive blood sugar monitoring might be needed for patients with urinary stone disease," the researchers conclude.

By Laura Dean

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