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Metabolic evaluation of urolithiasis and obesity in a midwestern pediatric population
John T Roddy1, Anas I Ghousheh2, Melissa A Christensen3
1Medical College of Wisconsin, Milwaukee, Wisconsin.
Insights
This study found no significant link between obesity and pediatric urolithiasis in otherwise healthy children. Obese and nonobese pediatric stone formers showed no distinct metabolic differences, suggesting obesity is not a primary risk factor.
Area of Science:
- Pediatric Nephrology
- Urology
- Public Health
Background:
- Urolithiasis incidence is rising in children, mirroring adult trends.
- The link between obesity and urolithiasis is established in adults but less clear in pediatric populations.
- Existing pediatric studies on obesity and stone formation yield inconclusive results.
Purpose of the Study:
- To investigate if healthy pediatric stone formers have a higher body mass index (BMI) than controls.
- To determine if obese pediatric stone formers exhibit distinct metabolic profiles compared to nonobese stone formers.
- To assess the role of obesity as a risk factor in pediatric urolithiasis.
Main Methods:
- Retrospective chart review of 117 patients aged 10-17 with upper tract urolithiasis and no comorbidities (2006-2011).
- Comparison of mean BMI in the study population against state-level data.
- Analysis of 24-hour urine collection results, comparing obese versus nonobese stone-forming patients.
Main Results:
- The obesity rate among pediatric urolithiasis patients was not significantly different from the general pediatric population.
- Overall 24-hour urine collection data revealed no statistically significant metabolic differences between obese and nonobese stone formers.
- The observed/expected ratio for obesity was 1.11 (95% CI 0.54-1.95).
Conclusions:
- Obesity is not confirmed as a risk factor for urolithiasis in otherwise healthy pediatric patients.
- No substantial metabolic distinctions were found between obese and nonobese pediatric stone formers.
- This study aligns with the majority of research failing to establish a definitive link between pediatric urolithiasis and obesity.
Purpose:
The incidence of urolithiasis has been proved to be increasing in the adult population, and evidence to date suggests that the same holds true for the pediatric population. While adult urolithiasis is clearly linked to obesity, studies of pediatric patients have been less conclusive. We hypothesized that a population of otherwise healthy children with stones would have an increased body mass index compared to a control population, and that obese pediatric stone formers would have results on metabolic assessment that are distinct from nonobese stone formers.
Materials And Methods:
We retrospectively reviewed the charts of all patients 10 to 17 years old with upper tract urolithiasis without comorbidities treated between 2006 and 2011. Mean body mass index of our population was compared to state data, and 24-hour urine collection results were compared between obese and nonobese patients with stones.
Results:
The obesity rate in 117 patients with urolithiasis did not differ significantly from the obesity rate derived from the 2007 National Survey of Children's Health (observed/expected ratio 1.11, 95% CI 0.54-1.95). Using t-test and chi-square comparisons, overall 24-hour urine collection data did not show statistically significant differences.
Conclusions:
Our results do not confirm obesity as a risk factor for pediatric urolithiasis in otherwise healthy patients. We also found no substantial metabolic differences between healthy nonobese stone formers and obese patients. While the pediatric literature is mixed, our study supports the majority of published series that have failed to establish a link between pediatric urolithiasis and obesity.
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