Impact of body mass index on size and composition of urinary stones: a systematic review and meta-analysis

Int Braz J Urol. 2023 May-Jun;49(3):281-298. doi: 10.1590/S1677-5538.IBJU.2022.0587.

Abstract

Background: Several studies have explored the impact of BMI on size and composition of urinary stones. Because there were controversies, a meta-analysis was necessary to be carried out to provide some evidence of the relationship of BMI and urolithiasis.

Materials and methods: PubMed, Medline, Embase, Web of Science databases, and the Cochrane Library were searched up to August 12th 2022 for eligible studies. The urolithiasis patients were summarized into two groups: BMI < 25 and ≥ 25 kg/m2. Summary weighted mean difference (WMD), relative risk (RR) and 95% confidence intervals (CI) were calculated through random effects models in RevMan 5.4 software.

Results: A total of fifteen studies involving 13,233 patients were enrolled in this meta-analysis. There was no significant correlation of BMI and size of urinary stone (WMD -0.13mm, 95% CI [-0.98, 0.73], p = 0.77). Overweight and obesity increased the risk of uric acid stones in both genders and in different regions (RR=0.87, [95% CI] = 0.83, 0.91, p<0.00001). There was a higher risk of calcium oxalate stones formation in overweight and obesity group in total patients (RR=0.95, [95% CI] = 0.91, 0.98, p = 0.006). The relationship of BMI and calcium phosphate was not observed in this meta-analysis (RR=1.12, [95% CI] = 0.98, 1.26, p = 0.09). Sensitivity analysis was performed and indicated similar results.

Conclusions: The current evidence suggests a positive association between BMI and uric acid and calcium oxalate stones. It would be of great guiding significance to consider losing weight when treating and preventing urinary stones.

Keywords: Body Mass Index; Obesity; Urinary Calculi.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Review

MeSH terms

  • Body Mass Index
  • Calcium Oxalate
  • Female
  • Humans
  • Male
  • Obesity / complications
  • Overweight / complications
  • Uric Acid
  • Urinary Calculi*
  • Urolithiasis* / etiology

Substances

  • Calcium Oxalate
  • Uric Acid

Grants and funding

FUNDING: National Natural Science Foundation of China (81671443 [J.L]).