二手煙對腎結石形成的影響不亞於吸煙

陳怡璇^1,2,3、李永進^1,2、詹鎮豪^1,2、王巽玄^1,2、沈榮宗^1,2、曹耀軒^1,2、吳怡萱^1,2、

黃書彬^2,4,5、耿俊閎^1,2,4,5*

高雄市立小港醫院 泌尿科^１；高雄醫學大學附設醫院 泌尿部^２；高雄市立大同醫院 泌尿科^３；

；高雄醫學大學^４；高雄醫學大學環境醫學研究中心⁵

The Impact of Secondhand Smoke on the Development of Kidney Stone Disease is Not Inferior to that of Smoking

Yi-Hsuan Chen^1,2,3、Yung-Chin Lee^1,2、Jhen-Hao Jhan^1,2、Hsun-Shuan Wang^1,2、Jung-Tsung Shen¹, Yao-Hsuan Tsao^1,2、Yi-Hsuan Wu^1,2、 Shu-Pin Huang^2,4,5、Jiun-Hung Geng^1,2,4,5*

Department of Urology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan^１; Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan²,  Department of Urology; Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan³; Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan⁴;Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan⁵

Purpose: Smoking and secondhand smoke (SHS) both increase the risk of kidney stone development. The aim of this study was to examine the effects of smoking and SHS on kidney stone disease (KSD) and to explore which has a greater impact on KSD.

Materials and Methods: We analyzed a total of 25,239 volunteers with no history of KSD participated in the Taiwan Biobank from 2008 to 2019. The presence of underlying and follow-up KSD was surveyed by a questionnaire asking. They were classified into three groups on the basis of smoking and SHS exposure, accessed with survey questionnaires; never-smokers with no SHS exposure, never-smokers with SHS exposure and ever-smokers groups. Logistic regression analyses were performed to determine the associations between the three groups and incident KSD.

Results: The mean age of participants was 51 years, and 66% were women. Incident kidney stone development was observed in 352 (2.0%), 50 (3.3%) and 240 (4.1%) participants in the never-smokers with no SHS exposure, never-smokers with SHS exposure and ever-smokers groups, respectively, during a mean follow-up of 47 months. The odds ratio (OR) of incident kidney stone was significantly higher in the never-smokers with SHS exposure (OR, 1.622; 95% confidence interval [95% CI], 1.195 to 2.202, p value = 0.002) and ever-smokers groups (OR, 1.283; 95% CI, 1.044 to 1.577, p value = 0.018) than in the never-smokers with no SHS exposure group after adjustment of confounders. In addition, never-smokers with SHS exposure had similar effects on the development of KSD than ever-smokers (OR, 190; 95% CI, 0.828 to 1.710, p value = 0.347).

Conclusion: Our study suggests that both smoking and SHS are a risk factor for developing KSD and that the impact of SHS is not inferior to that of smoking.