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Does insulin resistance promote calcium oxalate stone recurrence?
4th EULIS Meeting Vienna, Austria
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Does insulin resistance promote calcium oxalate stone recurrence? Eur Urol Suppl 2017; 16(7);e2499
Arzoz Fabregas M. 1 , Roca Antonio J. 2 , Granada Ybern M.L. 3 , Colomer Gallardo A. 1 , Freixa Sala R. 1 , Ibarz Servio L. 1 1
Hospital Universitari Germans Trias i Pujol, Dept. of Urology, Badalona, Spain, 2Hospital Universitari Germans Trias i Pujol, Dept. of Epidemiology,
Badalona, Spain, 3Hospital Universitari Germans Trias i Pujol, Dept. of Chemistry, Badalona, Spain Introduction & Objectives: Diabetes has been associated with calcium oxalate stones. Insulin resistance with secondary low urine pH and hypersisulinemia that promotes hypercalicuria have been proposed as a mechanism of lithogenesis. But since now there are no studies that evaluate insulin resistance as a risk of recurrence. The aim of this study is to determine whether insulin resistance is associated with calcium oxalate stone recurrence. Material & Methods: A total of 38 patients were enrolled in this case-controled study. All cases were calcium oxalate stones; 19 were first stone (FS) and 19 recurrent stones (RS) patients. All patients underwent metabolic evaluation including blood and 24-hour urine samples. Fasting insulin levels were included and insulin resistance was calculated as a homeostasis model of insulin resistance (HOMA-IR). In addition, epidemiological data and diet was reported. Results: There was no significant difference between FS (19) and RS (19) in age, gender or BMI. Normal insulin resistance (HOMA < 3) was found in 13 (13/38) RS and 15 (15/38) FS patients. Moderate insulin resistance (HOMA (>3-<5)) was found in 5 (5/38) and 4 (4/38), RS and FS respectively. Severe insulin resistance (HOMA <5) was only found in 1 (1/38) RS patient. There was no significant difference between FS and RS in any of insulin resistance category or insulin resistance value. Furthermore, there were no difference between blood glucose levels, urine pH or calcium urine between RS and FS patients. Conclusions: Despite the limited number of patients included in this study no significant association between FS and RS regarding diabetes and insulin resistance was observed. So diabetes and insulin resistance per se may not be a direct causal link of stone recurrence in calcium oxalate stone disease. In the future other risk factors of recurrence should be studied to find key elements of calcium oxalate stone disease prevention.
Eur Urol Suppl 2017; 16(7);e2499
33
Does insulin resistance promote calcium oxalate stone recurrence? Eur Urol Suppl 2017; 16(7);e2499
Arzoz Fabregas M. 1 , Roca Antonio J. 2 , Granada Ybern M.L. 3 , Colomer Gallardo A. 1 , Freixa Sala R. 1 , Ibarz Servio L. 1 1
Hospital Universitari Germans Trias i Pujol, Dept. of Urology, Badalona, Spain, 2Hospital Universitari Germans Trias i Pujol, Dept. of Epidemiology,
Badalona, Spain, 3Hospital Universitari Germans Trias i Pujol, Dept. of Chemistry, Badalona, Spain Introduction & Objectives: Diabetes has been associated with calcium oxalate stones. Insulin resistance with secondary low urine pH and hypersisulinemia that promotes hypercalicuria have been proposed as a mechanism of lithogenesis. But since now there are no studies that evaluate insulin resistance as a risk of recurrence. The aim of this study is to determine whether insulin resistance is associated with calcium oxalate stone recurrence. Material & Methods: A total of 38 patients were enrolled in this case-controled study. All cases were calcium oxalate stones; 19 were first stone (FS) and 19 recurrent stones (RS) patients. All patients underwent metabolic evaluation including blood and 24-hour urine samples. Fasting insulin levels were included and insulin resistance was calculated as a homeostasis model of insulin resistance (HOMA-IR). In addition, epidemiological data and diet was reported. Results: There was no significant difference between FS (19) and RS (19) in age, gender or BMI. Normal insulin resistance (HOMA < 3) was found in 13 (13/38) RS and 15 (15/38) FS patients. Moderate insulin resistance (HOMA (>3-<5)) was found in 5 (5/38) and 4 (4/38), RS and FS respectively. Severe insulin resistance (HOMA <5) was only found in 1 (1/38) RS patient. There was no significant difference between FS and RS in any of insulin resistance category or insulin resistance value. Furthermore, there were no difference between blood glucose levels, urine pH or calcium urine between RS and FS patients. Conclusions: Despite the limited number of patients included in this study no significant association between FS and RS regarding diabetes and insulin resistance was observed. So diabetes and insulin resistance per se may not be a direct causal link of stone recurrence in calcium oxalate stone disease. In the future other risk factors of recurrence should be studied to find key elements of calcium oxalate stone disease prevention.
Eur Urol Suppl 2017; 16(7);e2499