title: Hypertriglyceridemia is associated with increased risk for stone recurrence in patients with urolithiasis.
abstract: OBJECTIVE
  To assess the influence of dyslipidemia on urinary lithogenic metabolites and stone recurrence in stone formers.
  
  
  METHODS
  We retrospectively selected 321 patients with urolithiasis who had been followed up for >24 months between 2004 and 2009. Fasting blood samples were taken, and serum lipid profiles were measured. All subjects also underwent 24-hour urinary metabolic evaluation and stone analysis. The radiographic appearance of new stones was defined as stone recurrence.
  
  
  RESULTS
  There was no significant correlation between lipid profiles and 24-hour urine metabolites (all P >.05). Stone formers with hypertriglyceridemia had significantly higher urinary calcium, sodium, uric acid, magnesium, and potassium excretions. Only in a subgroup of uric acid stone, hypertriglyceridemia was significantly associated with decreased urinary pH. Those with low high-density lipoprotein (HDL) cholesterolemia had higher urinary sodium, magnesium, and potassium excretions, whereas those with high low-density lipoprotein (LDL) cholesterolemia had lower urinary sodium excretion. Stone analysis revealed that uric acid stones were more commonly found in patients with hypertriglyceridemia and low-HDL cholesterolemia. After a median follow-up of 35.0 months, 109 patients (34% of cohort) had stone recurrence. Stone recurrence was more common in the hypertriglyceridemia group compared with the normal triglyceridemia group (45.9% vs 29.7%; P = .005). The multivariate Cox regression model revealed that hypertriglyceridemia is associated independently with stone recurrence (hazard ratio, 1.857; 95% confidence interval, 1.211-2.847; P = .005). Kaplan-Meier curves showed similar results.
  
  
  CONCLUSIONS
  Our study showed that serum lipid profile is associated with urine metabolic alterations. More importantly, hypertriglyceridemia is independently associated with increased risk for stone recurrence in patients with urolithiasis.
authors.affiliation: Department of Urology, College of Medicine, Chungbuk National University, Cheongju, Republic of Korea.
authors.forename: Ho Won
authors.initials: HW
authors.lastname: Kang
authors.affiliation: Department of Urology, College of Medicine, Chungbuk National University, Cheongju, Republic of Korea.
authors.forename: Sung Pil
authors.initials: SP
authors.lastname: Seo
authors.affiliation: Department of Urology, College of Medicine, Chungbuk National University, Cheongju, Republic of Korea.
authors.forename: Won Tae
authors.initials: WT
authors.lastname: Kim
authors.affiliation: Department of Urology, College of Medicine, Chungbuk National University, Cheongju, Republic of Korea.
authors.forename: Yong-June
authors.initials: YJ
authors.lastname: Kim
authors.affiliation: Department of Urology, College of Medicine, Chungbuk National University, Cheongju, Republic of Korea.
authors.forename: Seok-Joong
authors.initials: SJ
authors.lastname: Yun
authors.affiliation: Department of Urology, College of Medicine, Chungbuk National University, Cheongju, Republic of Korea. Electronic address: lscuro@chungbuk.ac.kr.
authors.forename: Sang-Cheol
authors.initials: SC
authors.lastname: Lee
authors.affiliation: Department of Urology, College of Medicine, Chungbuk National University, Cheongju, Republic of Korea.
authors.forename: Wun-Jae
authors.initials: WJ
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D015228:Hypertriglyceridemia / Q000150:complications*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment; D052878:Urolithiasis / Q000453:epidemiology / Q000209:etiology*; D055815:Young Adult