Link between nephrolitiasis and the metabolic syndrome? C. Dzien 1), C. Dzien-Bischinger 1) A. Dzien 1) Medical Center Hentschelhof 1) A-6020 Innsbruck, Austria

Objectives The incidence of nephrolithiasis is given in means at 5%. The aim of our study was to investigate this incidence in a population of western Austria and to find possible correlations with routine parameters daily used and comorbidities. A further aim was to study a possible relationship with symptoms of the metabolic syndrome.

Methods In order to answer this question, a database collected by our medical outdoor center was evaluated. During a period of 22 years ( ) patients attended our medical practice, women N=8.697, men N= All of them were consecutively admitted to our medical center for diagnostic and therapeutics procedures

Methods Data collected for all patients included: gender, age, body mass index (BMI), body composition monitor (BCM), RR-sys, RR-dias, creatine, GFR, Na+, K+, Ca2+, Mg 2+, f-glucose, cholesterol, HDL-chol, LDL-chol, triglyceride, TSH During the evaluation period we have collected ICD-10 diagnoses.

Methods We are working with SQL data bank between 1992 to 2014 PATIENT: sex, title, name, date of birth, body size, profession, insurance, primary care physician, sports, nicotine consumption, food frequency questionare TREATMENT: date, treatment, weight, blood pressure (RR), BMI, HWR, body fat% ECG: SR PQ time LABORATORY: Laboratory species type all laboratory parameters are recorded in our database. In addition, the metric parameters of diagostic tests are recorded: (ergometry, etc.) THERAPY:drug, initiation and end of therapy, daily dose DRUGS: drug, ingredient, genericon, dosage, unit DIAGNOSIS:date, VESCA-ICD 10 diagnostic codesadress

Methods Nephrolithiasis was diagnosed in 261 patients (group 1) Characteristics of group 1: N = 261, fasting-glucose 95,1(±11,2)mg/dl, age (±5.34) years, women N = 114, men N = 147 A matched control group was characterized (group 2) by: N = 890, fasting-glucose 96,8(±12)mg/dl, age 54,02(±6,06) years, women N = 443, men N = 447. Fasting-glucose and age were in both groups not significantly different

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The diagnosis of nephrolithiasis was made at an age of 49.3 (±19.25) years, median 48.3 years. The incidence of nephrolithiasis in our population was 1,72%. The incidence of nephrolithiasis in summary of data was 0,2%. Results

Differences in laboratory values group 1 group 2 (nephrolithiasis)(without nephrolithiasis) body size(cm):172 (8,91) 176 (9,14) P <0,05 BCM(body fat %):28,5 (7,57)26,9 (7,2 1) p <0,05 RR sys.(mmHg):140 (21,66) 134 (18,1) p <0,03 RR dia.(mmHg): 86 (10,47) 84 (10,45) p <0,01 uric acids(µg/ml):5,31 (1,78) 4,93 (1,59)p <0,04 creatine(µg/ml)1,05 (0,27) 0,97 (0,27)p <0,01 HDL-chol.(µg/ml): 54,3 (16,5)59,3 (16,5)p <0,01 Prevalence of DM2: 29%15%

Results At the end of our observation the prevalence of type 2 diabetes was higher in the group of patients with nephrolithiasis compared to the control group. Patients with nephrolithiasis revealed lower HDL-chol. levels and higher blood pressures then the control group. (Indicating a higher prevalence of a metabolic syndrome) The comorbidity of group 1 with 17.9 diagnoses per patient was significantly higher compared with group 2 with 12.2 diagnoses per patient.

Conclusion In a medical outdoor center in Innsbruck nephrolithiasis shows with 1,72% a lower incidence than reported in the literature. The nephrolithiasis patients are more labor intensive because of the significantly higher comorbidity in particular a high proportion of diabetes mellitus 2b compared to the control group. Our data shows possible connections between nephrolithiasis and the metabolic syndrome. The early manifestation of nephrolithiasis may be the reason for the missing difference in f-glucose and triglyceride values.