Difference in 24-Hour Urine Composition between Diabetic and Non-Diabetic Adults without Nephrolithiasis

Wei Zhu; Zanlin Mai; Jing Qin; Xiaolu Duan; Yang Liu; Zhijian Zhao; Jian Yuan; Shaw P Wan; Guohua Zeng

doi:10.1371/journal.pone.0150006

Difference in 24-Hour Urine Composition between Diabetic and Non-Diabetic Adults without Nephrolithiasis

PLoS One. 2016 Feb 23;11(2):e0150006. doi: 10.1371/journal.pone.0150006. eCollection 2016.

Authors

Wei Zhu^{1

2}, Zanlin Mai^{1

2}, Jing Qin^{1

2}, Xiaolu Duan^{1

2}, Yang Liu^{1

2}, Zhijian Zhao^{1

2}, Jian Yuan^{1

2}, Shaw P Wan^{1

2}, Guohua Zeng^{1

2}

Affiliations

¹ Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
² Guangdong Key Laboratory of Urology, Guangzhou, Guangdong, China.

Abstract

Background: Diabetic patients are more likely to develop kidney stones than the general population. The underlying mechanisms for this disparity remain to be elucidated. Little is known about the relationship between urine composition and diabetes mellitus in non-stone-forming individuals. We sought to examine the differences in the 24-hour (24-h) urine composition between diabetic and non-diabetic adults who were not stone formers.

Methods: A convenience sample of 538 individuals without a history of nephrolithiasis, gout, hyperparathyroidism, or gastroenteric diseases participated in this study. The 24-h urine profiles of 115 diabetic adults were compared with those of 423 non-diabetic adults. Diabetes was defined by self-reported physician diagnosis or medication use. All participants were non-stone formers confirmed by urinary tract ultrasonography. Participants provided a fasting blood sample and a single 24-h urine collection for stone risk analysis. Student's t-test was used to compare mean urinary values. Linear regression models were adjusted for age, gender, body mass index, hypertension, fasting serum glucose, serum total cholesterol, estimated creatinine clearance rate and urinary factors.

Results: Univariable analysis showed that the diabetic participants had significantly higher 24-h urine volumes and lower urine calcium and magnesium excretions than non-diabetic participants (all P < 0.05). After multivariate adjustment, no significant differences in 24-h urine composition were observed between diabetic and non-diabetic participants except for a slightly increased 24-h urine volume in diabetic participants (all P > 0.05). The main limitation of this study is that the convenience samples and self-reported data may have been sources of bias.

Conclusion: Our data showed that there were no differences in 24-h urine composition between diabetic and non-diabetic adults who are not stone formers. The reason for it might be the improved glycemic control in diabetic individuals in our study. Therefore, a tighter glycemic control might reduce stone formation in diabetic adults.

Publication types

Comparative Study
Research Support, Non-U.S. Gov't

MeSH terms

Analysis of Variance
Diabetes Mellitus / urine*
Female
Humans
Kidney Calculi / complications
Male
Middle Aged
Time Factors

Grants and funding

This work was financed by a grant from National Natural Science Foundation, China (No. 81370804 and No. 81170652), Colleges and universities in Guangzhou Yangcheng scholars research project (No. 12A017S), and Science and technology project in Guangzhou (the people’s livelihood special major science and Technology) (No.201300000096). Guohua Zeng received this funding. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.