L-shaped association between the ratio of serum albumin to globulin and the risk of all-cause mortality among adults with kidney stones: a national cohort study.

IF 1.7 3区医学 Q4 ANDROLOGY

Translational andrology and urology Pub Date : 2025-03-30 Epub Date: 2025-03-26 DOI:10.21037/tau-2025-127

Sian Chen, Yiqiu Cheng, Fei Wang, Jinhai Wu, Xuejin Zhu, Luca Zanoli, Gino Pigatto Filho, Qi Gao, Yanfei Chen

{"title":"L-shaped association between the ratio of serum albumin to globulin and the risk of all-cause mortality among adults with kidney stones: a national cohort study.","authors":"Sian Chen, Yiqiu Cheng, Fei Wang, Jinhai Wu, Xuejin Zhu, Luca Zanoli, Gino Pigatto Filho, Qi Gao, Yanfei Chen","doi":"10.21037/tau-2025-127","DOIUrl":null,"url":null,"abstract":"Background: Kidney stones are a common urological disease with rising global prevalence and are influenced by immune, metabolic, and nutritional factors. The ratio of serum albumin to globulin, a marker of inflammation and nutritional status, has been linked to various inflammatory and chronic conditions, but its role in kidney stone risk and outcomes remains unclear. We aimed to determine the association between ratio of serum albumin to globulin and risk of kidney stones, as well as the impact of ratio of serum albumin to globulin on all-cause mortality in participants with kidney stones.Methods: Multivariable logistic regression was used to explore the association between ratio of serum albumin to globulin and the risk of kidney stones. Multivariate Cox regression and restricted cubic spline (RCS) were performed to clarify the relationship between ratio of serum albumin to globulin and the risk of all-cause mortality.Results: Among 31,091 study participants, 2,955 (9.5%) individuals had kidney stones. Multivariable logistic models demonstrated that each standard deviation (SD) increase in the ratio of serum albumin to globulin (SD =0.30) was associated with a 6% reduction in kidney stone risk. A total of 387 (13.1%) participants with kidney stones died for any reasons during a median follow-up of 6.2 years. The multivariable Cox model showed a significantly lower risk of all-cause mortality in the quartile (Q)2, Q3, and Q4 groups as compared to Q1 [Q2: adjusted hazard ratio (aHR) =0.84, 95% confidence interval (CI): 0.63-1.11; Q3: aHR =0.65, 95% CI: 0.48-0.86; Q4: aHR =0.63, 95% CI: 0.46-0.86; P for trend =0.04].Conclusions: A lower ratio of serum albumin to globulin was associated with an increased risk of kidney stones. Additionally, our study showed that at a cutoff point of 1.5, the association between ratio of serum albumin to globulin and all-cause mortality in participants with kidney stones was nonlinear L-shaped. However, due to the observational nature of the study, our study results should be interpreted with caution.","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 3","pages":"751-763"},"PeriodicalIF":1.7000,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11986477/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Translational andrology and urology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.21037/tau-2025-127","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/3/26 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"ANDROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Kidney stones are a common urological disease with rising global prevalence and are influenced by immune, metabolic, and nutritional factors. The ratio of serum albumin to globulin, a marker of inflammation and nutritional status, has been linked to various inflammatory and chronic conditions, but its role in kidney stone risk and outcomes remains unclear. We aimed to determine the association between ratio of serum albumin to globulin and risk of kidney stones, as well as the impact of ratio of serum albumin to globulin on all-cause mortality in participants with kidney stones.

Methods: Multivariable logistic regression was used to explore the association between ratio of serum albumin to globulin and the risk of kidney stones. Multivariate Cox regression and restricted cubic spline (RCS) were performed to clarify the relationship between ratio of serum albumin to globulin and the risk of all-cause mortality.

Results: Among 31,091 study participants, 2,955 (9.5%) individuals had kidney stones. Multivariable logistic models demonstrated that each standard deviation (SD) increase in the ratio of serum albumin to globulin (SD =0.30) was associated with a 6% reduction in kidney stone risk. A total of 387 (13.1%) participants with kidney stones died for any reasons during a median follow-up of 6.2 years. The multivariable Cox model showed a significantly lower risk of all-cause mortality in the quartile (Q)2, Q3, and Q4 groups as compared to Q1 [Q2: adjusted hazard ratio (aHR) =0.84, 95% confidence interval (CI): 0.63-1.11; Q3: aHR =0.65, 95% CI: 0.48-0.86; Q4: aHR =0.63, 95% CI: 0.46-0.86; P for trend =0.04].

Conclusions: A lower ratio of serum albumin to globulin was associated with an increased risk of kidney stones. Additionally, our study showed that at a cutoff point of 1.5, the association between ratio of serum albumin to globulin and all-cause mortality in participants with kidney stones was nonlinear L-shaped. However, due to the observational nature of the study, our study results should be interpreted with caution.

查看原文本刊更多论文

成人肾结石患者血清白蛋白与球蛋白的比值与全因死亡风险之间的l型相关性：一项国家队列研究。

背景：肾结石是一种常见的泌尿系统疾病，全球患病率不断上升，受免疫、代谢和营养因素的影响。血清白蛋白与球蛋白的比率是炎症和营养状况的标志，与各种炎症和慢性疾病有关，但其在肾结石风险和结局中的作用尚不清楚。我们的目的是确定血清白蛋白与球蛋白的比值与肾结石风险之间的关系，以及血清白蛋白与球蛋白的比值对肾结石患者全因死亡率的影响。方法：采用多变量logistic回归分析血清白蛋白/球蛋白比值与肾结石发生风险的关系。采用多因素Cox回归和限制性三次样条（RCS）分析血清白蛋白/球蛋白比值与全因死亡风险之间的关系。结果：在31091名研究参与者中，2955人（9.5%）患有肾结石。多变量logistic模型显示，血清白蛋白与球蛋白比率每增加一个标准差（SD =0.30），肾结石风险就会降低6%。在平均6.2年的随访期间，共有387名（13.1%）肾结石患者因各种原因死亡。多变量Cox模型显示，四分位数（Q2）、Q3和Q4组的全因死亡风险明显低于Q1组[Q2：校正风险比(aHR) =0.84, 95%可信区间（CI）： 0.63-1.11；Q3: aHR =0.65, 95% CI: 0.48 ~ 0.86；Q4: aHR =0.63, 95% CI: 0.46-0.86；P代表趋势=0.04]。结论：较低的血清白蛋白/球蛋白比率与肾结石风险增加有关。此外，我们的研究表明，在截断点为1.5时，肾结石患者血清白蛋白与球蛋白的比值与全因死亡率之间呈非线性l型关系。然而，由于研究的观察性，我们的研究结果应该谨慎解释。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Translational andrology and urology Medicine-Urology

CiteScore

4.10

自引率

5.00%

发文量

期刊介绍： ranslational Andrology and Urology (Print ISSN 2223-4683; Online ISSN 2223-4691; Transl Androl Urol; TAU) is an open access, peer-reviewed, bi-monthly journal (quarterly published from Mar.2012 - Dec. 2014). The main focus of the journal is to describe new findings in the field of translational research of Andrology and Urology, provides current and practical information on basic research and clinical investigations of Andrology and Urology. Specific areas of interest include, but not limited to, molecular study, pathology, biology and technical advances related to andrology and urology. Topics cover range from evaluation, prevention, diagnosis, therapy, prognosis, rehabilitation and future challenges to urology and andrology. Contributions pertinent to urology and andrology are also included from related fields such as public health, basic sciences, education, sociology, and nursing.