目的: 探讨高草酸尿(尿草酸≥45 mg/d)与性别、年龄及代谢性疾病(高血压、糖尿病)的相关性,为泌尿系结石的防治提供依据。方法: 回顾性分析2024年4月至2025年4月安阳市第六人民医院收治的200例泌尿系结石患者的临床资料,根据草酸尿水平将患者分为高草酸尿组102例,非高草酸尿组98例。收集两组患者的性别、年龄、高血压及糖尿病数据,通过卡方检验进行单因素分析,并对差异显著的因素进行二元Logistic回归分析。结果: 高草酸尿组与非高草酸尿组在性别(P＜0.001)和糖尿病患病(P=0.024)方面差异显著,在年龄和高血压患病方面无显著关联(P＞0.05)。多因素分析显示,男性高草酸尿风险显著高于女性(OR=3.534,95%CI:1.956-6.385),糖尿病患者发生高草酸尿风险低于非糖尿病患者(OR=0.505,95%CI:0.280-0.913)。青年、中年及老年组高草酸尿比例相近(51.4%、50.0%、51.6%)。结论: 性别和糖尿病是高草酸尿的独立影响因素,其中男性、非糖尿病患者风险更高,而年龄和高血压与高草酸尿无显著关联。临床应针对男性患者加强草酸代谢监测与饮食干预,糖尿病患者需综合管理其他代谢异常以降低结石发病风险。
Objective: To investigate the correlation between hyperoxaluria (oxaluria≥45 mg/d) and gender, age and metabolic diseases (hypertension, diabetes), providing evidence for the prevention and management of urinary calculi. Methods: The clinical data of 200 patients with urinary calculi admitted to Anyang Sixth People′s Hospital from April 2024 to April 2025 were retrospectively analyzed. According to the level of oxalic acid urine, the patients were divided into hyperoxaluria group (n=102) and non-hyperoxaluria group (n=98). The gender, age, hypertension and diabetes data of the two groups were collected. Univariate analysis was performed by chi-square test, and binary logistic regression analysis was performed on the factors with significant differences. Results: There were significant differences were observed between the hyperoxaluria and non-hyperoxaluria groups in gender (P＜0.001) and diabetes prevalence (P=0.024), while age and hypertension showed no significant associations(P＞0.05). Multivariate analysis revealed that males had a significantly higher risk of hyperoxaluria than females (OR=3.534, 95%CI: 1.956-6.385), while diabetic patients had a lower risk than non-diabetic patients (OR=0.505, 95%CI: 0.280-0.913). The proportion of hyperoxaluria in young, middle-aged and elderly groups was similar (51.4%, 50.0%, 51.6%). Conclusion: Gender and diabetes are independent influencing factors for hyperoxaluria, with males and non-diabetic individuals at higher risk, whereas age and hypertension showed no significant association. Clinically, male patients should prioritize oxaluria metabolism monitoring and dietary interventions, while diabetic patients require integrated management of other metabolic abnormalities to reduce the risk.
[1] 刘林伟. 泌尿系结石形成机制的研究进展[J]. 赣南医学院学报, 2017, 37(1): 158-162.
[2] Li HF, Xue XY, Meng GX, et al. The roles of bacteria on urolithiasis progression and associated compounds[J]. Biochem Pharmacol, 2025, 237: 116958.
[3] 李朋埕, 谷亚龙, 格桑罗布. 评估泌尿系结石与非结石患者尿液代谢物水平的差异[J]. 西藏医药, 2024, 45(6): 36-37.
[4] 朴敏虎, 金明吉, 陈勃翰, 等. 延边地区300例泌尿系统结石成分分析及不同结石成分在不同民族和性别之间的差异[J]. 中外女性健康研究, 2015(17): 239-239, 241.
[5] Praus F, Schönthaler M. Modifiable and non-modifiable risk factors for urolithiasis[J]. Urologe A, 2019, 58(11): 1281-1288.
[6] Herout R, Oehlschläger S. Geschlechtsspezifische unterschiede der harnsteinerkrankung unter beachtung des oxalatstoffwechsels der leber[J]. Aktuelle Urol, 2025, 56(2): 145-149.
[7] Divya G, Albert A, Singab ANB, et al. Renoprotective effect of tectorigenin glycosides isolated from Iris spuria L. (Zeal) against hyperoxaluria and hyperglycemia in NRK-49Fcells[J]. Nat Prod Res, 2021, 35(6): 1029-1034.
[8] Xiang H, Chen HQ, Liu YY, et al. Role of insulin resistance and the gut microbiome on urine oxalate excretion in ob/ob mice[J]. Physiol Rep, 2022, 10(14): e15357.
[9] Zeng ZP, Qiu JX, Chen Y, et al. Altered gut microbiota as a potential risk factor for coronary artery disease in diabetes: a two-sample bi-directional mendelian randomization study[J]. Int J Med Sci, 2024, 21(2): 376-395.
[10] Metry EL, Garrelfs SF, Deesker LJ, et al. Determinants of kidney failure in primary hyperoxaluria type 1: findings of the European hyperoxaluria consortium[J]. Kidney Int Rep, 2023, 8(10): 2029-2042.
[11] Siener R, Hesse A. The effect of different food forms on the urine composition and the risk of calcium oxalate stone formation[J].Z Ernahrungswiss, 1993, 32(1): 45-55.
[12] Kim YJ, Park MS, Kim WT, et al. Hypertension influences recurrent stone formation in nonobese stone formers[J]. Urology, 2011, 77(5): 1059-1063.
[13] 陈星, 王国民, 郭剑明. 代谢综合征与肾结石关系的研究进展[J]. 复旦学报(医学版), 2013, 40(6): 752-756.
