Metabolic syndrome and uric acid nephrolithiasis: insulin resistance in focus

Spatola, Leonardo; Ferraro, Pietro Manuel; Gambaro, Giovanni; Badalamenti, Salvatore; Dauriz, Marco

doi:10.1016/j.metabol.2018.02.008

Cited by 84 publications

(58 citation statements)

References 94 publications

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“…Fluctuated urea cycle and AAs metabolism may result in the accumulation of urate and urea in the kidney and serum (Table and Figure H). It was also reported that a high level of urate inhibited insulin signaling, resulting in insulin resistance, oxidative stress, damage to the pancreatic β cells and decreased utilization of glucose …”

Section: Discussionmentioning

confidence: 99%

Glucomannans Alleviated the Progression of Diabetic Kidney Disease by Improving Kidney Metabolic Disturbance

Chen

Nie

et al. 2019

Molecular Nutrition Food Res

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Scope: This study is aimed to investigate the kidney protective effects of glucomannans from Dendrobium officinale stem, konjac, and Aloe vera leaves on type 2 diabetic rats and explore its potential mechanisms. Methods and results: Pathological and metabolomics analysis methods are adopted in this study. Compared with the model group, lower levels of fasting blood glucose, serum insulin, and glycated serum protein are observed in glucomannan-treated groups. Concentrations of serum low-density lipoprotein cholesterol, total cholesterol, triacylglycerols, and nonesterified fatty acid are significantly decreased by glucomannan treatment. Furthermore, glucomannan treatment significantly decreased the levels of uric acid, creatinine, urea in serum, and glycosuria, ketone body, and protein in the urine. Histopathological analysis showed that glucomannan treatment normalized the architecture of glomerulus. Metabolomic analysis indicated glucomannan treatment could improve urea cycle, metabolism of lipid, glucose, and amino acids on diabetes. In particular, the konjac glucomannan treatment is more effective in lipid and glucose regulation. Glucomannan from D. officinale is more effective in balancing the urea cycle and amino acid metabolism. Conclusions: The disturbance of lipid, glucose, and amino acid metabolism is closely associated with the advancement of diabetic kidney disease, and glucomannan treatment could be efficient in the management of diabetic kidney disease.

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Section: Discussionmentioning

confidence: 99%

Glucomannans Alleviated the Progression of Diabetic Kidney Disease by Improving Kidney Metabolic Disturbance

Chen

Nie

et al. 2019

Molecular Nutrition Food Res

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“…Nevertheless, there are situations in which this is difficult to achieve, or requires great effort and willpower by the patient. For example, patients with metabolic syndrome have high urinary uric acid concentrations, and a urinary pH below 5.5, making them especially predisposed for uric acid kidney stones [ 28 ]. The current treatments thus require modification of the diet, with reduced consumption of purine-containing foods, and administration of urinary alkalinizers or xanthine oxidase inhibitors to reduce uric acid supersaturation.…”

Section: Discussionmentioning

confidence: 99%

Effect of Consumption of Cocoa-Derived Products on Uric Acid Crystallization in Urine of Healthy Volunteers

et al. 2018

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The purpose of this study was to determine the effects of consumption of different cocoa-derived products on uric acid crystallization in urine of 20 healthy volunteers. Participants were requested to select the specific diet that they wished to follow during the 12 h prior to collection of urine. The only restriction was that the diet could not include any product with cocoa, coffee, or caffeine. On the first day, each volunteer followed their selected diet, and an overnight 12 h urine sample was collected as the baseline urine. After seven days on an unrestricted diet, each volunteer repeated the same diet with 20 g of milk chocolate, chocolate powder, or dark chocolate during breakfast and another 20 g during dinner. Overnight 12 h urine samples were then collected. Urine volume, pH, oxalate, creatinine, uric acid, theobromine, and a uric acid crystallization test were determined for each sample. The results for all 20 patients show that uric acid crystallization was significantly lower following the consumption of chocolate powder or dark chocolate relative to baseline or following the consumption of milk chocolate. The results indicated that increased concentrations of urinary theobromine reduced the risk of uric acid crystallization.

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“…In recent years, metabolic syndrome has been found to be the predominant cause of uric acid nephrolithiasis [13,92]. The underlying pathophysiological process has resulted from unduly acidic urine pH, linked to insulin resistance [93] and to a lesser extent from a high dietary purine content and increased endogenous purine metabolism with consequent overproduction of uric acid [94].…”

Section: Uric Acidmentioning

confidence: 99%

Risk of Kidney Stones: Influence of Dietary Factors, Dietary Patterns, and Vegetarian–Vegan Diets

et al. 2020

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Nephrolithiasis is a common medical condition influenced by multiple environmental factors, including diet. Since nutritional habits play a relevant role in the genesis and recurrence of kidney stones disease, dietary manipulation has become a fundamental tool for the medical management of nephrolithiasis. Dietary advice aims to reduce the majority of lithogenic risk factors, reducing the supersaturation of urine, mainly for calcium oxalate, calcium phosphate, and uric acid. For this purpose, current guidelines recommend increasing fluid intake, maintaining a balanced calcium intake, reducing dietary intake of sodium and animal proteins, and increasing intake of fruits and fibers. In this review, we analyzed the effects of each dietary factor on nephrolithiasis incidence and recurrence rate. Available scientific evidence agrees on the harmful effects of high meat/animal protein intake and low calcium diets, whereas high content of fruits and vegetables associated with a balanced intake of low-fat dairy products carries the lowest risk for incident kidney stones. Furthermore, a balanced vegetarian diet with dairy products seems to be the most protective diet for kidney stone patients. Since no study prospectively examined the effects of vegan diets on nephrolithiasis risk factors, more scientific work should be made to define the best diet for different kidney stone phenotypes.

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Metabolic syndrome and uric acid nephrolithiasis: insulin resistance in focus

Cited by 84 publications

References 94 publications

Glucomannans Alleviated the Progression of Diabetic Kidney Disease by Improving Kidney Metabolic Disturbance

Glucomannans Alleviated the Progression of Diabetic Kidney Disease by Improving Kidney Metabolic Disturbance

Effect of Consumption of Cocoa-Derived Products on Uric Acid Crystallization in Urine of Healthy Volunteers

Risk of Kidney Stones: Influence of Dietary Factors, Dietary Patterns, and Vegetarian–Vegan Diets

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