Comparison of metabolic changes for stone risks in 24-hour urine between non- and postmenopausal women

Abstract

BackgroundTo explore the differences of 24-hour urine compositions associated with urolithiasis between non- and postmenopausal females.MethodsThe 24-hour urine samples of female participants were collected from May 2013 to July 2014 along with national cross-sectional study of urolithiasis among adults aged ≥18 years in China. The exclusion criteria for the participants were: serum creatinine > 133μmol/L, with urinary tract infection, gout, hyperthyroidism, malignancy, had a history of cancer, kidney stones, enterectomy, had taken thiazide diuretics, allopurinol, vitamin supplement, potassium citrate or calcium supplements during the past two weeks. The compositions associated with urinary stone in 24-hour urine were measured and compared between non-and postmenopausal women.ResultsA total of 603 24-hour urine samples of female participants were analyzed. 354 women with a mean age of 52.5± 14.03 (range 19–84) years met the criteria, including 160 non-menopausal women and 194 postmenopausal women. Compared to the non-menopausal women, postmenopausal women had a lower secretion of citrate (p = 0.043), magnesium (p = 0.001) and creatinine (p = 0.001) in 24h urine. Multivariate linear regression analysis showed that the menopause status was associated with the changes in magnesium (p = 0.003) and creatinine (p = 0.002) secretion, whereas not with the changes in citrate (p = 0.402) secretion.ConclusionsPostmenopausal women have a significant lower secretion of magnesium in their 24-hour urine than non-menopausal ones. We suppose that might be associated with increased risk of urinary stone formation among postmenopausal women.

Dietary vinegar prevents kidney stone recurrence via epigenetic regulations

“…After obtaining informed consent, each participant completed an initial questionnaire - a self-reporting system that collected information regarding his or her social and demographic status (e.g. gender and age), personal and family health history, lifestyle, and the use of vitamins and medications [[19], [20], [21], [22]]. The 24-h urine profiles of 61 adults who consume vinegar daily (>15 ml/day) were compared with those of 61 adults who do not using a propensity score-matching analysis.…”

Role of Citrate in Pathophysiology and Medical Management of Bone Diseases

“…The circulating citrate levels and the citrate content in bone are markedly reduced in animals with age-related or ovariectomy-induced bone loss [85]. A low citrate excretion, less severe than true hypocitraturia fixed at less than 320 mg per day, has been described in postmenopausal women [11,33] and in subjects with a low bone mass [34,83]. Nurses’ Health Study II considered an ongoing cohort of 108,639 participants from whom information on menopause and kidney stones was obtained.…”

“…Hypocitraturia is a response to the elevated acid load occurring in metabolic acidosis, since there is a notable increase in citrate reabsorption in the renal proximal tubule when the tubular pH decreases [16]. In this regard, there is consensus in considering citraturia as a biomarker for monitoring diet and the metabolism-dependent systemic acid-base status, even in subjects without overt metabolic acidosis [33,34,35].…”

“…As stated for dietary modifications, the rationale of the published trials was based on the assumption that citrate-based supplements may be useful as alkalising agents which neutralise the effects of an excessive acid load [16,65,119,120,121]. Other than diets rich in salt and animal protein [128], several conditions may induce low-grade acidosis, and the majority of them are age-related, such as menopause [33], subclinical inflammatory status [137], and decreased renal function [68]. On the basis of this assumption, Lambert et al (2015) carried out a meta-analysis aimed at determining whether alkaline potassium salts, including potassium citrate and potassium bicarbonate, had some effect on calcium metabolism and bone health [138].…”

Protective Cellular Mechanism of Estrogen Against Kidney Stone Formation: A Proteomics Approach and Functional Validation

“…During the past two decades, several studies have attempted to address this hypothesis, especially in calcium oxalate (CaOx) stone, which is the most common type of kidney stones found globally . However, the data obtained from different studies were inconclusive and cellular mechanisms underlying such protective effects of estrogen remained unclear …”