title: Systemic endothelial function measured by flow-mediated dilation is impaired in patients with urolithiasis.
abstract: Some in vitro and animal studies have shown endothelial dysfunction in hyperoxaluria models indicating its role in pathogenesis of urolithiasis and relation to CVD. The aim of this study was to investigate endothelial function in patients with urolithiasis in relation to urinary stone risk factors and metabolic parameters. A total of 120 subjects without any known CVD (60 with urolithiasis and 60 healthy subjects) were included into study. Fasting blood and 24-h urine samples were collected to study metabolic parameters (glucose and lipids) and urine stone risk factors (oxalate, citrate, uric acid, and calcium, pH). Endothelial function was assessed as flow-mediated dilation (FMD) at the brachial artery. Age, sex, and body mass index were similar in patients and controls. Of urine stone risk factors, oxalate and citrate were higher in patients than controls. Fasting blood glucose, total LDL cholesterol, and triglyceride were higher, and HDL cholesterol was lower in patients than controls. Although within normal limits systolic blood pressure was higher in patient group, patients with urolithiasis had a lower %FMD than controls. Percent FMD was negatively correlated with urinary oxalate/creatinine ratio (p = 0.019, r = -0.315), calcium/creatinine ratio (p = 0.0001, r = -0.505) age (p < 0.001, r = -0.694), BMI (p < 0.001, r = -0.838), total cholesterol (p < 0.001, r = -0.559), and triglyceride (p < 0.001, r = -0.529). Urine oxalate/creatinine ratio was positively correlated with age (p = 0.01, r = 0.327) and calcium/creatinine ratio with BMI (p = 0.001, r = 0.410). This is the first study demonstrating endothelial dysfunction in human subjects with urolithiasis. This indicates a possible predictive role of urolithiasis in future development of cardiovascular diseases.
authors.affiliation: Department of Radiology, Haydarpasa Numune Education and Training Hospital, Istanbul, Turkey.
authors.forename: Esin
authors.initials: E
authors.lastname: Yencilek
authors.affiliation: Department of Internal Medicine, Bagcilar Education and Training Hospital, Istanbul, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Sarı
authors.affiliation: Department of Urology, Medical Faculty, Yeditepe University, Istanbul, Turkey.
authors.forename: Faruk
authors.initials: F
authors.lastname: Yencilek
authors.affiliation: Department of Nephrology, Umraniye Education and Training Hospital, Istanbul, Turkey.
authors.forename: Ezgi
authors.initials: E
authors.lastname: Yeşil
authors.affiliation: Department of Endocrinology and Metabolism, Medical Faculty, Yeditepe University, Istanbul, Turkey. haydin@yeditepe.edu.tr.|Yeditepe Universitesi Hastanesi, İçerenkoy Mahallesi, Hastane Yolu Sokak No: 102-104, Atasehir, Istanbul, 34752, Turkey. haydin@yeditepe.edu.tr.
authors.forename: Hasan
authors.initials: H
authors.lastname: Aydın
mesh_terms: D000328:Adult; D001775:Blood Circulation / Q000502:physiology*; D001786:Blood Glucose; D001794:Blood Pressure; D001916:Brachial Artery / Q000503:physiopathology; D002318:Cardiovascular Diseases / Q000503:physiopathology / Q000517:prevention & control; D016022:Case-Control Studies; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D002951:Citrates / Q000652:urine; D003404:Creatinine / Q000652:urine; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010070:Oxalates / Q000652:urine; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D014545:Urinary Calculi / Q000097:blood / Q000503:physiopathology* / Q000652:urine
chemical_list: D001786:Blood Glucose; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D002951:Citrates; D010070:Oxalates; D014280:Triglycerides; D003404:Creatinine
keywords: Cardiovascular risk; Endothelial dysfunction; Flow-mediated dilation; Urolithiasis