title: Visceral obesity: A new risk factor for stone disease.
abstract: BACKGROUND
  We examined the relationship between stone disease and the amount of visceral adipose tissue measured with unenhanced computed tomography (CT).
  
  
  METHODS
  We included 149 patients with complaints of flank pain and kidney stones detected by CT, from August 2012 to April 2013. In addition, as the control group we included 139 healthy individuals, with flank pain within the same time period, with no previous history of urological disease and no current kidney stones identified by CT. Patients were analyzed for age, gender, body mass index, amount of visceral and subcutaneous adipose tissue, and serum level of low-density lipoprotein and triglyceride.
  
  
  RESULTS
  There were no differences between groups in terms of gender and age (p = 0.27 and 0.06, respectively). Respective measurements for the stone and control groups for body mass index were 29.1 and 27.6 kg/m(2); for visceral fat measurement 186.0 and 120.2 cm(2); and for subcutaneous fat measurements 275.9 and 261.9 cm(2) (p = 0.01; 0.01 and 0.36, respectively). Using multivariate analysis, the following factors were identified as increasing the risk of kidney stone formation: hyperlipidemia (p = 0.003), hypertension (p = 0.001), and ratio of visceral fat tissue to subcutaneous fat tissue (p = 0.01). Our study has its limitations, including its retrospective nature, its small sample size, possible selection bias, and missing data. The lack of stone composition data is another major limitation of our study.
  
  
  CONCLUSIONS
  The ratio of visceral to subcutaneous adipose tissue, in addition to obesity, hyperlipidemia, and hypertension, was identified as an emerging factor in the formation of kidney stones.
authors.affiliation: Kemalpasa State Hospital, Urology Clinic, Turkey;
authors.forename: Ilker
authors.initials: I
authors.lastname: Akarken
authors.affiliation: Tepecik Teaching and Research Hospital, Department of Urology, Turkey.
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Tarhan
authors.affiliation: Tepecik Teaching and Research Hospital, Department of Urology, Turkey.
authors.forename: Rahmi Gökhan
authors.initials: RG
authors.lastname: Ekin
authors.affiliation: Tepecik Teaching and Research Hospital, Department of Urology, Turkey.
authors.forename: Özgür
authors.initials: Ö
authors.lastname: Çakmak
authors.affiliation: Tepecik Teaching and Research Hospital, Department of Urology, Turkey.
authors.forename: Gökan
authors.initials: G
authors.lastname: Koç
authors.affiliation: Tepecik Teaching and Research Hospital, Department of Urology, Turkey.
authors.forename: Yusuf Özlem
authors.initials: YÖ
authors.lastname: İlbey
authors.affiliation: Tepecik Teaching and Research Hospital, Department of Urology, Turkey.
authors.forename: Ferruh
authors.initials: F
authors.lastname: Zorlu