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首页> 外文学位 >High urinary calcium excretion and familial aggregation of hypertension, kidney stone disease, obesity, excessive weight gain and type 2 diabetes in patients with calcareous stones.
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High urinary calcium excretion and familial aggregation of hypertension, kidney stone disease, obesity, excessive weight gain and type 2 diabetes in patients with calcareous stones.

机译：钙质结石患者的尿钙排泄量高以及高血压，肾结石病，肥胖，体重增加过多和2型糖尿病的家族聚集。

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摘要

Associations between kidney stone disease (KSD), hypertension, obesity, excessive weight gain and type 2 diabetes suggest the possibility that susceptible individuals share a common genetic background and are influenced by similar environmental factors. To test this hypothesis, this thesis examined (1) the aggregation of these conditions in families of KSD patients with hypercalciuria, and (2) the combined effect of dietary potassium (K+), measured by its urinary excretion, and hypercalciuria on the familial risk of these conditions. Consecutive KSD patients, aged 18-50 years, were recruited from a population-based Kidney Stone Center and collected a 24-hour urine sample. The first-degree relatives of eligible subjects (n=333) and their spouse were interviewed by telephone to collect demographic and health information. Familial aggregation was assessed using Generalized Estimating Equations. Multivariate-adjusted odds ratios (OR) revealed significant associations between hypercalciuria in patients and hypertension and KSD in first-degree relatives and specifically in siblings (OR and 95% confidence interval for hypertension = 2.9, 1.4-6.2 and for KSD = 1.9, 1.03-3.5). No significant associations were found in parents or spouses, or in patients with hyperuricosuria. Similarly, no aggregation with other conditions was observed. When examining the effects of urinary K+, relatives of low K+ excretors had a higher frequency of obesity and excessive weight gain, but not hypertension, KSD or diabetes, than those of normal excretors. In hypercalciuric patients, however, low K+ excretion predicted hypertension (OR = 3.3, 1.5-7.4) and KSD (OR = 2.9, 1.1-7.3) in first-degree relatives, and diabetes in siblings (OR = 4.1, 1.1-15.6). No conditions aggregated in spouses. In a validation study, increased 24-hour urinary K+ was associated with a progressive increase in diet quality score, the intake of foods recommended by current dietary guidelines and a lower BMI, diastolic blood pressure and heart rate. While an environmental effect cannot be fully excluded, the findings suggest that the disturbance in calcium metabolism in hypertension and KSD has a genetic basis. Furthermore, the combination of a low K+ diet, an environmental factor, and hypercalciuria, a suspected inherited trait, identified a subset of patients with an apparent common pathway for the development of KSD, hypertension and possibly diabetes.
机译：肾结石病（KSD），高血压，肥胖，体重增加过多和2型糖尿病之间的关联表明，易感人群具有共同的遗传背景并受相似的环境因素影响的可能性。为了检验这一假设，本论文研究了（1）KSD高钙血症患者家庭中这些疾病的聚集情况，以及（2）通过尿排泄量和高钙尿对家庭风险的饮食钾（K +）的综合作用这些条件。从人群基础的肾脏结石中心招募了18至50岁的连续KSD患者，并收集了24小时尿液样本。通过电话采访符合条件的受试者（n = 333）的一级亲属及其配偶，以收集人口统计和健康信息。使用广义估计方程评估家族聚集。多元校正比值比（OR）显示患者高钙尿症与高血压以及一级亲属特别是兄弟姐妹中的KSD之间存在显着相关性（高血压的OR和95％置信区间分别为2.9、1.4-6.2和KSD = 1.9、1.03 -3.5）。在父母或配偶或尿酸尿过多的患者中未发现明显的关联。类似地，未观察到与其他条件的聚集。在检查尿K +的影响时，低K +排泄者的亲属比正常排泄者有更高的肥胖和肥胖增加频率，而高血压，KSD或糖尿病则没有。然而，在高钙血症患者中，一级亲属的低K +排泄预测为高血压（OR = 3.3，1.5-7.4）和KSD（OR = 2.9，1.1-7.3），兄弟姐妹为糖尿病（OR = 4.1，1.1-15.6） 。配偶中没有条件汇总。在一项验证性研究中，增加的24小时尿K +与饮食质量得分的逐步提高，当前饮食指南建议的食物摄入以及较低的BMI，舒张压和心率有关。虽然不能完全排除环境影响，但研究结果表明，高血压和KSD中钙代谢的紊乱具有遗传基础。此外，低钾饮食，环境因素和高钙尿症（一种可疑的遗传性状）的组合，发现了一部分患者，这些患者具有明显的常见途径，可导致KSD，高血压和糖尿病。

著录项

  • 作者

    Mente, Andrew.;

  • 作者单位

    University of Toronto (Canada).;

  • 授予单位 University of Toronto (Canada).;
  • 学科 Health Sciences Medicine and Surgery.;Health Sciences Public Health.
  • 学位 Ph.D.
  • 年度 2007
  • 页码 305 p.
  • 总页数 305
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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