Data Sheet 1_Prevalence of kidney stones based on metabolic health and weight criteria: reports from the national health and nutrition examination survey 2007-2018 data analysis.pdf

ObjectiveUsing data from the NHANES collected between 2007-2018, this study aimed to investigate the relationship between the prevalence of kidney stones and metabolically healthy obesity (MHO) and measure the effect of physical activity as a modifying factor.
MethodsThis cross-sectional analysis included 12,498 participants aged ≥20 years who were categorized into six groups based on their metabolic status (healthy or unhealthy) and BMI (normal, overweight, and obesity). Kidney stone history was self-reported. Weighted logistic regression models, adjusted for demographic characteristics, comorbidities, and lifestyle variables, were applied to calculate odds ratios and 95% confidence intervals. Subgroup analyses were conducted based on the degree of physical activity.
ResultsThe overall prevalence of kidney stones was 10.20%. Participants with metabolically unhealthy obesity (MUO) had the highest prevalence of kidney stones (14.5%), followed by individuals with MHO (11.1%). After full adjustment, compared to participants with MHN, the MHO and MUO groups exhibited significantly greater risks of kidney stones (MHO: OR = 2.10, 95% CI:1.47–2.98, P < 0.001; MUO: OR = 1.98, 95% CI:1.45–2.67, P < 0.001). Physical activity was associated with a decreased risk of kidney stones, particularly among individuals with MUO. Stratified analyses revealed no significant interaction effects by age, sex, or race.
ConclusionObesity, irrespective of metabolic health status, was significantly associated with a higher prevalence of kidney stones. Higher levels of physical activity were correlated with lower risks of kidney stones, particularly in metabolically unhealthy individuals. These results underscore the importance of managing body weight and maintaining physical activity as key strategies to prevent kidney stones.

研究目的
本研究依托2007-2018年美国国家健康与营养检查调查（National Health and Nutrition Examination Survey, NHANES）的数据，旨在探讨肾结石患病率与代谢健康型肥胖（metabolically healthy obesity, MHO）之间的关联，并评估体力活动作为调节因素的效应。

研究方法
本项横断面分析共纳入12498名年龄≥20岁的参与者，依据代谢状态（健康或不健康）与体质量指数（Body Mass Index, BMI）划分为六组：体质量指数分为正常、超重与肥胖三个层级，结合两种代谢状态形成六个亚组。肾结石患病史通过自我报告形式收集。本研究采用经人口学特征、合并症及生活方式变量校正的加权逻辑回归模型，计算比值比（odds ratios, OR）与95%置信区间（confidence intervals, CI）。研究同时基于体力活动程度开展亚组分析。

研究结果
肾结石总体患病率为10.20%。代谢不健康型肥胖（metabolically unhealthy obesity, MUO）参与者的肾结石患病率最高，达14.5%，其次为代谢健康型肥胖（MHO）人群，患病率为11.1%。经全变量校正后，与代谢健康体质量正常（metabolically healthy normal, MHN）参与者相比，MHO组与MUO组的肾结石患病风险均显著升高：MHO组OR=2.10，95%CI：1.47~2.98，P<0.001；MUO组OR=1.98，95%CI：1.45~2.67，P<0.001。体力活动与肾结石患病风险降低相关，尤其在代谢不健康型肥胖人群中更为显著。分层分析显示，年龄、性别或种族未呈现显著交互效应。

研究结论
无论代谢健康状态如何，肥胖均与肾结石患病率升高显著相关。更高水平的体力活动与更低的肾结石患病风险相关，尤其在代谢不健康人群中更为明显。本研究结果凸显了管控体质量与维持体力活动作为肾结石预防关键策略的重要性。