Supplementary Material for: Sex Differences in Kidney Stone Disease in Chinese Patients with Type 2 Diabetes Mellitus

<b><i>Objectives:</i></b> To investigate the characteristics of kidney stone disease (KSD) among the Chinese population with type 2 diabetes mellitus (T2DM) and identify sex-specific factors associated with KSD. <b><i>Methods:</i></b> A single-center, cross-sectional analysis was performed among Chinese patients with T2DM. KSD was identified by ultrasonography or computed tomography results. Demographic data, physical measurements, laboratory measurements, comorbidities, and related medication data were collected and analyzed. Binary logistic regression was used to explore the associated factors. <b><i>Results:</i></b> A total of 7,257 patients with T2DM were included in the study, of which 56.1% were male and 15.0% were diagnosed with KSD. The male-to-female ratio for KSD among T2DM patients was 1.35. Among all the T2DM patients, male gender, HOMA2-IR, uric acid, and renal cysts were independent risk factors for KSD development, whereas serum phosphorus and the use of angiotensin-converting enzyme inhibitors (ACEIs) were independent protective factors for KSD. Among male diabetic patients, triglycerides, HOMA2-IR, renal cysts, and urinary tract infections were all associated with a greater risk of KSD. In contrast, serum phosphorus was associated with a lower risk of KSD. Among female diabetic patients, systolic blood pressure and HOMA2-B were both contributing factors, and ACEIs acted as a protective factor for KSD. <b><i>Conclusion:</i></b> Among Chinese patients with T2DM, approximately 1 in 7 patients was affected by KSD, and the prevalence was twice as high as that in the general Chinese population. The factors associated with KSD varied by sex among T2DM patients. Focusing on these factors is beneficial for reducing the risk of KSD and delaying kidney damage in diabetic patients.

**<i>研究目的</i>：** 探究中国2型糖尿病（type 2 diabetes mellitus, T2DM）人群中肾结石病（kidney stone disease, KSD）的患病特征，并明确与KSD相关的性别特异性影响因素。
**<i>研究方法</i>：** 本研究针对中国2型糖尿病患者开展单中心横断面分析。通过超声检查或计算机断层扫描（computed tomography, CT）结果确诊KSD。收集并分析受试者的人口学资料、体格测量指标、实验室检测指标、合并症及相关用药数据。采用二元logistic回归分析探索相关影响因素。
**<i>研究结果</i>：** 本研究共纳入7257名2型糖尿病患者，其中男性占比56.1%，15.0%的患者确诊为KSD。2型糖尿病患者中KSD的男女患病比为1.35。在全部受试者中，男性性别、胰岛素抵抗指数（HOMA2-IR）、血尿酸水平及肾囊肿是KSD发生的独立危险因素，而血清磷水平与血管紧张素转换酶抑制剂（angiotensin-converting enzyme inhibitors, ACEIs）的使用为KSD的独立保护因素。在男性糖尿病患者中，甘油三酯水平、HOMA2-IR、肾囊肿及尿路感染均与KSD发病风险升高相关；与之相反，血清磷水平与KSD发病风险降低相关。在女性糖尿病患者中，收缩压与胰岛β细胞功能指数（HOMA2-B）均为KSD的危险因素，而ACEIs的使用则为KSD的保护因素。
**<i>结论</i>：** 中国2型糖尿病患者中约七分之一受KSD困扰，其患病率为中国普通人群的两倍。2型糖尿病患者中与KSD相关的影响因素存在性别差异。关注上述影响因素，有助于降低糖尿病患者的KSD发病风险并延缓肾脏损伤。