title: Dyslipidaemia in overweight children and adolescents is associated with an increased risk of kidney stones.
abstract: OBJECTIVE
  There is conflicting evidence about the role of obesity in paediatric nephrolithiasis. This Polish study explored the influence of nutritional status and lipid disturbances on urinary lithogenic factors and the risk of kidney stone formation in children and adolescents from three to 18 years of age.
  
  
  METHODS
  We carried out serum lipid profile evaluations and 24-h urine chemistry analyses on 493 overweight/obese paediatric participants (mean age 13 years) without nephrolithiasis and 492 healthy normal weight sex and age-matched controls.
  
  
  RESULTS
  A third (33%) of the study group had blood lipid disturbances, with more acidic urine, lower urinary citrate excretion and a higher fraction of ionised calcium and higher Bonn Risk Index than the controls. The participants' body mass index standard deviation score (BMI Z-score) was positively correlated with urinary oxalate and uric acid and negatively correlated with citrate excretion. Total cholesterol, low-density lipoprotein cholesterol and triglycerides correlated negatively with citraturia, while high-density lipoprotein cholesterol correlated positively.
  
  
  CONCLUSIONS
  The main factor that predisposed overweight and obese children to kidney stones was hypocitraturia. Urinary citrate excretion was related to both BMI Z-scores and all lipid fraction abnormalities. However, hypercholesterolaemia and particularly low-density lipoprotein hypercholesterolaemia seemed to play a major role.
authors.affiliation: Department of Paediatric Surgery, Medical University of Bialystok, Bialystok, Poland.
authors.forename: J K
authors.initials: JK
authors.lastname: Kirejczyk
authors.affiliation: Department of Paediatrics and Nephrology, Medical University of Bialystok, Bialystok, Poland.
authors.forename: A
authors.initials: A
authors.lastname: Korzeniecka-Kozerska
authors.affiliation: Department of Paediatrics, Endocrinology, Diabetology with Cardiology Division, Medical University of Bialystok, Bialystok, Poland.
authors.forename: M
authors.initials: M
authors.lastname: Baran
authors.affiliation: Department of Medical Chemistry, Medical University of Bialystok, Bialystok, Poland.
authors.forename: H
authors.initials: H
authors.lastname: Porowska
authors.affiliation: Department of Paediatrics and Nephrology, Medical University of Bialystok, Bialystok, Poland.
authors.forename: T
authors.initials: T
authors.lastname: Porowski
authors.affiliation: Department of Paediatrics and Nephrology, Medical University of Bialystok, Bialystok, Poland.
authors.forename: A
authors.initials: A
authors.lastname: Wasilewska
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D002118:Calcium / Q000652:urine; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D019343:Citric Acid / Q000652:urine; D003430:Cross-Sectional Studies; D050171:Dyslipidemias / Q000150:complications* / Q000378:metabolism*; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000209:etiology*; D008297:Male; D009752:Nutritional Status; D009765:Obesity / Q000150:complications* / Q000378:metabolism*; D010070:Oxalates / Q000652:urine; D011044:Poland; D011446:Prospective Studies; D012307:Risk Factors; D014527:Uric Acid / Q000652:urine
chemical_list: D010070:Oxalates; D014527:Uric Acid; D019343:Citric Acid; D002118:Calcium
keywords: Children; Lipid profile; Metabolic syndrome; Obesity; Urolithiasis