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Liu C, Zhang H, Yang Y, Cao Y, Liang D. Association Between Dietary Zinc Intake and Increased Renal Function in US Adults. Biol Trace Elem Res 2024; 202:3871-3885. [PMID: 38015328 DOI: 10.1007/s12011-023-03969-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 11/19/2023] [Indexed: 11/29/2023]
Abstract
We aimed to investigate the association between the dietary zinc intake and the risk of albuminuria, low estimated glomerular filtration rate (eGFR), and chronic kidney disease (CKD) in the US general population. This study was a cross-sectional study utilizing the data from the 2003-2018 National Health and Nutrition Examination Survey. Albuminuria was defined as urinary albumin:creatinine ratio (ACR) > 30 mg/g. Low eGFR was defined as an eGFR of less than 60 mL/min/1.73 m2. CKD is characterized by albuminuria or low eGFR. Multivariate logistic regression analysis, subgroup analyses, interaction tests, and restricted cubic spline (RCS) analysis were performed in this study. For 37,195 enrolled participants in this study, the mean dietary zinc intake was 11.85 ± 0.07 mg/day, and the rate of albuminuria, low eGFR, and CKD was 9.37%, 6.68%, and 14.10%, respectively. Participants with a higher dietary zinc intake showed a lower risk of albuminuria, low eGFR, and CKD. In the fully adjusted model, we found that participants in the highest dietary zinc intake quartile had 26% lower odds of the rate of CKD than those in quartile 1. Subgroup analyses showed that dietary zinc intake was positively associated with the risk of low eGFR in participants who were now smokers. The potential nonlinear relationship between dietary zinc intake and the risk of CKD and albuminuria was also revealed. Higher dietary zinc intake was significantly associated with a lower likelihood of CKD, which might be helpful in kidney function protection among the general population.
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Affiliation(s)
- Chang Liu
- School of Medicine, Nankai University, Tianjin, China
| | - Hao Zhang
- The Eighth Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Yuwei Yang
- The Eighth Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Yan Cao
- The Eighth Medical Center, Chinese PLA General Hospital, Beijing, China.
| | - Dan Liang
- Department of Endocrine, People's Hospital of Chongqing Liangjiang New Area, Chongqing, China.
- West China Clinical Medical College of Sichuan University, Sichuan, China.
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Zhang C, Yan Y, Zhang C. Evaluation of imprecision in the different detection methods of Zn based on 5 years of data from an external quality assessment program in China. J Trace Elem Med Biol 2024; 84:127451. [PMID: 38636293 DOI: 10.1016/j.jtemb.2024.127451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 04/10/2024] [Accepted: 04/11/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND This study examines the imprecision of zinc (Zn) measurements across various clinical detection methods by analyzing the external quality assessment (EQA) data from 2018 to 2022. The findings of this study aim to offer recommendations for enhancing Zn measurements. METHODS Participating laboratories were grouped into peer categories based on the detection methods. The robust mean and coefficient of variation (CV) of the samples were calculated following ISO 13528 guidelines. The evaluation criteria for optimal, desirable, and minimum allowable imprecision in Zn estimation are 2.50%, 5.05%, and 7.55%, respectively, based on biological variation. Furthermore, the study examined inter-lab CVs, inter-method bias, and the passing rate. The impact of sample concentration on CVs and the pass rate was also investigated. RESULTS Over the past five years, 4283 laboratories participated in the EQA program, showing a high pass rate that improved as sample concentration increased. Differential pulse polarography (DPP) demonstrated stable and low CVs (0.61-1.86%). Although differential pulse stripping (DPS) was less stable than DPP, it still exhibited a low CV (0.71-3.10%). Graphite furnace atomic absorption spectrometry (GFAAS) and flame atomic absorption spectrometry (FAAS) performed similarly and displayed stable CVs (2.39-4.42%) within the acceptable range of desirable imprecision (5.05%). However, the CVs for ICP-MS were unacceptable in three out of the five years (5.28-6.20%). In 2022, the number of participating laboratories for DDP, DPS, GFAAS, FAAS and ICP-MS is 131, 35, 35, 820 and 72, respectively. CONCLUSION This study provides reliable insights into the imprecision of Zn measurements in clinical laboratories. The findings indicate that additional efforts are required to reduce the imprecision of ICP-MS in Zn measurements.
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Affiliation(s)
- Chao Zhang
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, PR China; Peking Union Medical College, Beijing, PR China.
| | - Ying Yan
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, PR China
| | - Chuanbao Zhang
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, PR China.
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Taha SAY, Shokeir AA, Mortada WI, Awadalla A, Barakat LAA. Effect of Copper and Zinc Ions on Biochemical and Molecular Characteristics of Calcium Oxalate Renal Stones: a Controlled Clinical Study. Biol Trace Elem Res 2024; 202:410-422. [PMID: 37191760 PMCID: PMC10764588 DOI: 10.1007/s12011-023-03686-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 04/26/2023] [Indexed: 05/17/2023]
Abstract
Contradictory results are existed in the literature regarding the impact of trace elements on the pathogenesis of calcium oxalate (CaOx) stone patients. Therefore, the aim of our study was to investigate the effect of Cu and Zn on biochemical and molecular characteristics of CaOx stones. Plasma and urine concentrations of Cu and Zn in 30 CaOx stones patients and 20 controls were determined by flame atomic absorption spectrometry (FAAS). Urinary levels of citric acid and oxalate were measured by commercial spectrophotometric kits. Blood levels of glutathione reduced (GSH) and catalase (CAT) were determined as markers of antioxidant activity, while blood malondialdehyde (MDA) and urine level of nitric oxide (NO) were used to assess oxidative stress. Gene expression of MAPk pathway (ERK, P38, and JNK) were estimated. The plasma and urine levels of Cu were significantly increased in the patient group compared to those of controls, while the levels of Zn were decreased. Excessive urinary excretion of citric acid and oxalate were found among CaOx stone patients. The GSH and CAT concentration were significantly reduced in CaOx stones patients compared to healthy group. The plasma MDA and urine NO concentration were significantly increased in CaOx stones patients compared to control group. The expressions of the studied genes were significantly increased in CaOx stones patients. These findings suggest that alteration in Cu and Zn might contribute to pathogenesis of CaOx patients through oxidative stress and MAPK pathway genes (ERK, P38 and JNK).
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Affiliation(s)
- Shaimaa A Y Taha
- Center of Excellence for Genome and Cancer Research, Urology and Nephrology Center, Mansoura University, Mansoura, 35516, Egypt
| | - Ahmed A Shokeir
- Center of Excellence for Genome and Cancer Research, Urology and Nephrology Center, Mansoura University, Mansoura, 35516, Egypt.
| | - Wael I Mortada
- Clinical Chemistry Laboratory, Urology and Nephrology Center, Mansoura University, Mansoura, 35516, Egypt
| | - Amira Awadalla
- Center of Excellence for Genome and Cancer Research, Urology and Nephrology Center, Mansoura University, Mansoura, 35516, Egypt
| | - Lamiaa A A Barakat
- Department of Biochemistry, Faculty of Science, Port Said University, Port Said, Egypt
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Dargahi A, Rahimpouran S, Rad HM, Eghlimi E, Zandian H, Hosseinkhani A, Vosoughi M, Valizadeh F, Hossinzadeh R. Investigation of the link between the type and concentrations of heavy metals and other elements in blood and urinary stones and their association to the environmental factors and dietary pattern. J Trace Elem Med Biol 2023; 80:127270. [PMID: 37506467 DOI: 10.1016/j.jtemb.2023.127270] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 07/04/2023] [Accepted: 07/23/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND Kidney and urinary tract stones are among the most common and important health problems, the prevalence of which is increasing nowadays due to a sedentary lifestyle, improper nutrition, destructive habits in fluid consumption, and improper use of medications. One of the causing factors in the formation of urinary stones is heavy metals. These metals present in tiny amounts in the environment and enter the nature and food cycle due to industrial activities and practices that are not compliant with environmental laws. METHODS In this context, the present case-control study was conducted to determine the concentrations of heavy metals and other urinary stone-forming elements in both blood and urinary stones and investigate their relationship with environmental factors and dietary patterns in people with urinary stones in Ardabil city in 2022. The sampling of blood and urinary stones was done randomly from patients with urinary stones who were admitted to the Urology Clinic of Imam Reza Hospital, Ardabil. ICP-MS was used to measure the concentrations of heavy metals in the samples. The obtained data were analysed by chi-square test, ANOVA test, t-test, and Tukey test. RESULTS The body mass index (BMI) was 27.39 ± 3.72 in the case group and 26.37 ± 2.95 in the control group. The copper and selenium concentrations in blood and urinary stones were higher than in other metals. There was a significant relationship between the history of kidney stones and the probability of developing kidney stones. Moreover, a meaningful relationship was found between the concentration of lead element and the formation of kidney stones. The results showed a significant difference in the concentration of nickel and copper in people who consumed vegetables on a daily basis with those with different types of kidney stones. CONCLUSION The comparison amongst the concentration of heavy metals in various kinds of urinary stones showed that the amount of lead metal was higher in calcium phosphate stones than in calcium oxalate stones.
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Affiliation(s)
- Abdollah Dargahi
- Social Determinants of Health Research Center, Ardabil University of Medical Sciences, Ardabil, Iran; Department of Environmental Health Engineering, Khalkhal University of Medical Sciences, Khalkhal, Iran.
| | - Shima Rahimpouran
- Social Determinants of Health Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Hamed Mohseni Rad
- Department of Surgery, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Elika Eghlimi
- Student of Medicine, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Hamed Zandian
- Social Determinants of Health Research Center, Ardabil University of Medical Sciences, Ardabil, Iran; Centre for Public Health and Wellbeing, School of Health and Social Wellbeing, College of Health, Science and Society, University of the West of England, Bristol, UK.
| | - Ali Hosseinkhani
- Department of Surgery, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Mehdi Vosoughi
- Social Determinants of Health Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Farzin Valizadeh
- Department of Surgery, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Rahman Hossinzadeh
- Department of Surgery, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
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Ke R, He Y, Chen C. Association between oxidative balance score and kidney stone in United States adults: analysis from NHANES 2007-2018. Front Physiol 2023; 14:1275750. [PMID: 38028789 PMCID: PMC10654971 DOI: 10.3389/fphys.2023.1275750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 10/17/2023] [Indexed: 12/01/2023] Open
Abstract
Purpose: To investigate the relationship between the Oxidative Balance Score (OBS) and kidney stone risk using NHANES 2007-2018 data, and to explore potential mechanisms and population-specific effects. Materials and methods: Data from the NHANES 2007-2018 were analyzed. OBS was calculated based on 16 dietary components and 4 lifestyle components. Multivariate logistic regression was employed to investigate the relationship between OBS and kidney stone. Further stratified analyses were conducted to examine the associations across different subgroups. Results: A total of 19,799 participants were included in the study. There was a consistent inverse association between OBS and the risk of kidney stones (OR = 0.97; 95% CI: 0.96-0.99). After dividing the participants into quartiles based on OBS, compared to the lowest quartile of OBS, the risk of kidney stones in the highest quartile of OBS was reduced by 33% (95% CI 0.50-0.89; p = 0.002). This association was consistent across both dietary and lifestyle OBS scores. The protective effect of OBS was notably pronounced among Non-Hispanic white and Other race groups, and among individuals with a higher level of education. However, the association was not significant among individuals with diabetes. Conclusion: A higher OBS, indicating a balance skewed towards antioxidants, is associated with a reduced risk of kidney stones, especially among specific population subgroups. These findings underscore the potential role of oxidative balance in kidney stone pathogenesis and highlight the importance of considering individual and population-specific factors in future research and preventive strategies.
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Affiliation(s)
| | | | - Chaohao Chen
- Department of Urology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
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Yang J, Wu W, Amier Y, Li X, Wan W, Yu X. Causal relationship of genetically predicted circulating micronutrients levels with the risk of kidney stone disease: a Mendelian randomization study. Front Nutr 2023; 10:1132597. [PMID: 37671199 PMCID: PMC10476526 DOI: 10.3389/fnut.2023.1132597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 04/12/2023] [Indexed: 09/07/2023] Open
Abstract
Background Current studies have reported conflicting associations between circulating micronutrient levels and kidney stone disease (KSD). We aimed to elucidate the causal relationship between circulating micronutrient levels and KSD by a two-sample Mendelian randomization (MR) analysis. Methods Total of 36 single nucleotide polymorphisms (SNPs) from published genome-wide association studies (GWAS) significantly associated with eight micronutrients (vitamin B12, folic acid, magnesium, iron, phosphorus, copper, zinc, and selenium) were used as instrumental variables. The GWAS summary data associated with KSD (8,060 cases and 301,094 controls) were obtained from the FinnGen consortium. Inverse variance weighted was the main MR analysis method. MR-Pleiotropy RESidual Sum and Outlier (MR-PRESSO), weighted median and MR-Egger were used to assess pleiotropy and heterogeneity. Results Genetically predicted circulating vitamin B12 and zinc levels were causally associated with the risk of KSD (vitamin B12: OR: 1.17, 95% CI: 1.04-1.32, p = 0.008; zinc: OR: 1.15, 95% CI: 1.03-1.28, p = 0.015). We found no evidence that other circulating micronutrients were associated with risk of KSD. p-value for Cochrane Q test, MR Egger intercept test, and MR-PRESSO were >0.05, indicating no significant heterogeneity or horizontal pleiotropy in this MR analysis. Conclusion Increasing circulating zinc levels may increase the risk of KSD. More studies are needed to provide evidence on whether genetically predicted circulating vitamin B12 and zinc levels are a risk factor for KSD.
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Affiliation(s)
| | | | | | | | | | - Xiao Yu
- Department of Urology, Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Hassan Z, Hassan A, Riaz M, Khan AA, Ul-Allah S, Shehzad U, Khurshid M, Bakhsh A, Shah JM, Manzoor Z. Increased health risk assessment in different vegetables grown under untreated sewerage irrigation regime due to higher heavy metals accumulation. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:86189-86201. [PMID: 37402048 DOI: 10.1007/s11356-023-28413-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 06/18/2023] [Indexed: 07/05/2023]
Abstract
Heavy metals are environmental pollutants and carcinogenic for human health if ingested. In developing countries, including Pakistan, untreated sewerage water is one of the major sources of irrigation for vegetable production in the vicinities of urban areas which might be toxic to human health due to heavy metals contamination. The present study was conducted to investigate the uptake of heavy metals by sewage water application and its impact on human health. The experiment consisted of five vegetable crops (Raphanus sativus L, Daucus carota, Brassica rapa, Spinacia oleracea, and Trigonella foenum-graecum L.) and two irrigation sources (clean water irrigation and sewage water irrigation). Each treatment was three time replicated for all five vegetables, and standard agronomic practices were applied. The results demonstrated that shoot and root growth in radish, carrot, turnip, spinach, and fenugreek was enhanced significantly with sewerage water, probably due to enhanced organic matter. However, pithiness was observed in the root of radish under sewerage water treatment. Very high concentrations of Cd, up to 7.08 ppm in turnip roots while up to 5.10 ppm in fenugreek shoot, were observed, and other vegetables also contained higher concentrations of Cd. Zn concentrations in the edible parts of carrot (control (C) = 129.17 ppm, sewerage (S) = 164.10 ppm), radish (C = 173.73 ppm, S = 253.03), turnip (C = 109.77 ppm, S = 149.67 ppm), and fenugreek (C = 131.87 ppm, S = 186.36 ppm) were increased by sewerage water treatment but a decrease in Zn concentration in spinach (C = 262.17 ppm, S = 226.97 ppm) was observed. Fe concentration in edible parts of carrot (C = 888.00 ppm, S = 524.80 ppm), radish (C = 139.69 ppm, S = 123.60 ppm), turnip (C = 195.00 ppm, S = 121.37 ppm), and fenugreek (C = 1054.93 ppm, S = 461.77 ppm) were also decreased by sewerage water treatment while spinach leaves had accumulated higher Fe (C = 1560.33 ppm, S = 1682.67 ppm) in sewerage water treatment. The highest bioaccumulation factor value was 4.17 for Cd in carrots irrigated with sewerage water. The maximum value of bioconcentration factor was 3.11 for Cd in turnip under control, and the highest value of translocation factor was 4.82 in fenugreek irrigated with sewerage water. Daily intake of metals and health risk index (HRI) calculation indicated that HRI for Cd was more than 1, suggesting toxicity in these vegetables while HRI for Fe and Zn is still under safe limit. Correlation analysis among different traits of all vegetables under both treatments revealed valuable information for selecting traits in the next crop breeding programs. It is concluded that untreated sewerage-irrigated vegetables, highly contaminated with Cd, are potentially toxic for human consumption and should be banned in Pakistan. Furthermore, it is suggested that the sewerage water should be treated to eliminate toxic compounds, particularly Cd, before irrigation usage and non-edible/phytoremediation crops might be grown in contaminated soils.
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Affiliation(s)
- Zeshan Hassan
- College of Agriculture, University of Layyah, Layyah, 31200, Pakistan
| | - Ammara Hassan
- Department of Physiology, Fatima Jinnah Medical University/Sir Ganga Ram Hospital, Lahore, Pakistan
| | | | - Azhar Abbas Khan
- College of Agriculture, University of Layyah, Layyah, 31200, Pakistan
| | - Sami Ul-Allah
- College of Agriculture, University of Layyah, Layyah, 31200, Pakistan
| | - Umbreen Shehzad
- College of Agriculture, University of Layyah, Layyah, 31200, Pakistan
| | - Muhammad Khurshid
- Institute of Biochemistry and Biotechnology, University of The Punjab, Lahore, Pakistan
| | - Ali Bakhsh
- Department of Plant Breeding and Genetics, Ghazi University, Dera Ghazi Khan, Pakistan
| | | | - Zahid Manzoor
- College of Agriculture, University of Layyah, Layyah, 31200, Pakistan.
- National Key Laboratory of Crop Genetic Improvement, Department of Crop Genetics and Breeding, College of Plant Science and Technology, Huazhong Agricultural University, Wuhan, China.
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Wang X, Zhang Y, Zhao F, Li J, Yian Y. Symptomatic recurrence rate of upper urinary tract calculi in children after endourological procedures. J Pediatr Urol 2022; 18:141.e1-141.e7. [PMID: 35300915 DOI: 10.1016/j.jpurol.2021.09.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 09/22/2021] [Accepted: 09/27/2021] [Indexed: 12/21/2022]
Abstract
INTRODUCTION The recurrence rate of paediatric urolithiasis was less reported, especially in Asians. Our aim was to verify the symptomatic recurrence rate of Chinese paediatric urolithiasis and to determine the predictive factors for stone recurrence. MATERIALS AND METHODS We performed a retrospective review of children who presented with first upper urinary tract calculi from June 2014 to September 2019. For the follow-up, we generated Kaplan-Meier plots with time to stone recurrence and Cox proportional hazard regression analyses were applied. The recurrence was defined as a new symptomatic stone on ultrasound and/or computerized tomography. RESULTS A total of 230 children with a median age of 5 yr (IQR 4-8) were included. Calcium oxalate was found in 72% of stones, and calcium apatite was found in 32% of stones. After a median follow-up of 39.5 months, 34 (14.8%) children had stone recurrence. Median time to stone recurrence was 31 months. Among them, 31 (91.2%) required surgical intervention. Older children (P < 0.01), higher BMI (HBM) (P < 0.01) and higher stone burden (P < 0.01) were shown to be associated with stone recurrence in the univariate analysis. The multivariate Cox regression analysis showed that children with stone burden > 2 cm3 had a higher risk of recurrence (HR 4.84, 95%CI 2.28-10.3). Children with HBM had an increased recurrence rate compared to normal BMI children (HR 2.99, 95%CI 1.36-6.56). CONCLUSIONS The symptomatic recurrence rate of paediatric urolithiasis in Chinese is not as high as that reported in Caucasians. HBM and higher stone burden are associated with higher recurrence rates.
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Affiliation(s)
- Xiaochuan Wang
- Department of Urology, Beijing Friendship Hospital, Capital Medical University, No. 95, Yongan Road, Xicheng District, Beijing, People's Republic of China.
| | - Yu Zhang
- Department of Urology, Beijing Friendship Hospital, Capital Medical University, No. 95, Yongan Road, Xicheng District, Beijing, People's Republic of China.
| | - Fangzhou Zhao
- Department of Urology, Beijing Friendship Hospital, Capital Medical University, No. 95, Yongan Road, Xicheng District, Beijing, People's Republic of China.
| | - Jun Li
- Department of Urology, Beijing Friendship Hospital, Capital Medical University, No. 95, Yongan Road, Xicheng District, Beijing, People's Republic of China.
| | - Ye Yian
- Department of Urology, Beijing Friendship Hospital, Capital Medical University, No. 95, Yongan Road, Xicheng District, Beijing, People's Republic of China.
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Sun Y, Wang Y, Wang D, Zhou Q. Dietary zinc intake, supplemental zinc intake and serum zinc levels and the prevalence of kidney stones in adults. J Trace Elem Med Biol 2020; 57:126410. [PMID: 31570252 DOI: 10.1016/j.jtemb.2019.126410] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 09/07/2019] [Accepted: 09/23/2019] [Indexed: 01/11/2023]
Abstract
OBJECTIVE The association between zinc intake and the risk of kidney stones remains controversial. We examined the associations between dietary zinc intake, supplemental zinc intake and serum zinc levels and the prevalence of kidney stones in adults. METHODS Adult participants from the 2007-2016 NHANES were included. Restricted cubic splines were adopted to assess the dose-response relationships. RESULTS Dietary zinc intake was linearly associated with the prevalence of kidney stones (Pfor non-linearity = 0.50), and the odds ratios (95% confidence intervals) of kidney stones were 0.75 (0.51-1.04) for 10 mg/day, 0.65 (0.39-0.97) for 20 mg/day, 0.53 (0.30-0.94) for 30 mg/day and 0.45 (0.22-0.95) for 40 mg/day. The linear relationship was also observed among women and overweight/obese individuals. No association was found between supplemental zinc intake and the prevalence of kidney stones. A non-linear relationship was found between serum zinc levels and the prevalence of kidney stones (Pfor non-linearity = 0.02), and the odds ratios (95% confidence intervals) of kidney stones were 0.52 (0.33-0.82) for 70 ug/dL, 0.43 (0.24-0.77) for 90 ug/dL, 0.56 (0.32-0.98) for 110 ug/dL and 0.77 (0.37-1.62) for 130 ug/dL. The non-linear relationship was also observed among men and overweight/obese individuals. CONCLUSIONS Dietary zinc intake and serum zinc levels were inversely associated with the prevalence of kidney stones in adults, and there may be effect modification by participant sex and body mass index. The present analysis is limited in its ability to establish causality.
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Affiliation(s)
- Yaofei Sun
- Department of Urology, Weifang People's Hospital, Guangwen Street, No. 151, 261000, China
| | - Yanchen Wang
- Department of Urology, Weifang People's Hospital, Guangwen Street, No. 151, 261000, China
| | - Dawei Wang
- Department of Urology, Weifang People's Hospital, Guangwen Street, No. 151, 261000, China
| | - Quan Zhou
- Department of Urology, Weifang People's Hospital, Guangwen Street, No. 151, 261000, China.
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Ferraro PM, Gambaro G, Curhan GC, Taylor EN. Intake of Trace Metals and the Risk of Incident Kidney Stones. J Urol 2018; 199:1534-1539. [PMID: 29391176 DOI: 10.1016/j.juro.2018.01.077] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2018] [Indexed: 01/12/2023]
Abstract
PURPOSE The association between the intake of trace metals and the risk of incident stones has not been longitudinally investigated. MATERIALS AND METHODS We performed a prospective analysis of 193,551 participants in the Health Professionals Follow-up Study, and the Nurses' Health Study I and II. During a followup of 3,316,580 person-years there was a total of 6,576 incident stones. We used multivariate regression models to identify associations of the intake of zinc, iron, copper and manganese with the risk of stones. In a subset of participants with 24-hour urine collections we examined the association between the intake of trace metals and urine composition. RESULTS After multivariate adjustment total and dietary intakes of zinc and iron were not significantly associated with incident stones. A higher intake of manganese was associated with a lower risk of stones. The pooled HR of the highest quintile of total manganese intake compared with the lowest intake was 0.82 (95% CI 0.68-0.98, p = 0.02). Total but not dietary copper intake was marginally associated with a higher risk of stones (pooled HR 1.14, 95% CI 1.02-1.28, p = 0.01). There were no statistically significant associations of the total intake of manganese and copper with urinary supersaturation. CONCLUSIONS Zinc and iron intake was not associated with a risk of stones. Copper intake may be associated with a higher risk in some individuals. Higher total manganese intake was associated with a lower risk of stones but not with traditional 24-hour urinary composite markers of stone risk. Further research is needed to elucidate the mechanisms by which manganese may reduce kidney stone formation.
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Affiliation(s)
- Pietro Manuel Ferraro
- Nefrologia, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy.
| | - Giovanni Gambaro
- Nefrologia, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy
| | - Gary C Curhan
- Renal Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Eric N Taylor
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Division of Nephrology and Transplantation, Maine Medical Center, Portland, Maine
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The role of zinc in urinary stone disease. Int Urol Nephrol 2018; 50:879-883. [PMID: 29344880 DOI: 10.1007/s11255-017-1784-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 12/29/2017] [Indexed: 01/26/2023]
Abstract
In recent years, the role of trace elements in lithogenesis has received steadily increasing attention. It is well documented that some trace elements can influence the morphology and speed of the crystallization process. Zinc has been found in significant amounts in calcium stones relative or organic stones (uric acid and cystine), probably substituting calcium in crystals because of their similarity in charge and size. High Zn levels are present in carbapatite of Randal's plaques suggesting that zinc could promote calcium phosphate deposition in the medullar interstitium. Large-scale epidemiological studies have found an association of increased dietary zinc intake with increased risk of nephrolithiasis in adults but not in adolescents. Most studies examining urinary zinc levels in adults have reported increased urinary Zn excretion in stone formers. In an experimental model of organic crystal formation produced by silencing xanthine dehydrogenase in Drosophila fly, maneuvers that reduce Zn excretion have shown to reduce crystal formation in the lumen of the Malpighian tubules. This is curious because this is not a model of calcium stone formation. Finally, zinc supplementation has been associated with increased admissions for urinary lithiasis in men, but no change in calcium stone formation in children. Perhaps, some of these contradicting findings can be explained in part by the in vitro effect of zinc on the type and amount of calcium phosphate formed: At low concentrations, Zn inhibited the crystal growth of dicalcium phosphate dihydrate, octacalcium phosphate, and apatite, and at higher concentrations, it promoted the formation of amorphous calcium phosphate. Thus, further studies are needed to see whether manipulation of Zn metabolism can inhibit calcium stone formation.
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Ferraro PM, Curhan G. Zinc as a Contributing Factor in Lithogenesis: Not Yet Ready for the Clinic. J Urol 2017; 197:1187-1188. [DOI: 10.1016/j.juro.2017.02.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2017] [Indexed: 11/26/2022]
Affiliation(s)
- Pietro Manuel Ferraro
- Division of Nephrology, Fondazione Policlinico Universitario A. Gemelli, Catholic University of the Sacred Heart, Rome, Italy
| | - Gary Curhan
- Channing Division of Network Medicine/Renal Division, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
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Wan J. This Month in Pediatric Urology. J Urol 2017. [DOI: 10.1016/j.juro.2017.02.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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