Atorvastatin治療可以改善尿液結石危險因素，並提高腎結石患者的血清睾固酮濃度
黃鶴翔、1廖寶祺
國立成功大學附設醫院泌尿科、1國立成功大學工業衛生科暨環境醫學研究所
Atorvastatin treatment can improve urine stone risk factors and increase serum testosterone levels in kidney stone patients
Ho-Shiang Huang, 1 Pao-Chi Liao
Department of Urology, National Cheng Kung University, Tainan, Taiwan; 1 Industrial Health Branch and Environmental Medicine Institute, National Cheng Kung University, Tainan, Taiwan.
Purpose: To evaluate the changes in serum testosterone level in patients with kidney stone disease and the impact of atorvastatin on serum testosterone and 24-h urine chemicals in stone patients with a higher risk of ASCVD.
Materials and Methods: One hundred eight patients presented to the Urology clinic were included and stratified into low and higher risk of ASCVD. 20 mg/d atorvastatin was prescribed to the higher risk group. Serum levels of lipids, creatinine, total testosterone, albumin, and SHBG were measured at baseline and 12 weeks after treatment.
Results: Relative to the controls, kidney stone patients had higher BMI and Serum TG levels and lower serum total testosterone (TT) and free testosterone (FT) levels, and higher 24-h urine calcium and low urine citrate amounts significantly. However, only BMI, LDL, TT, and urine Ca remained significant difference in multivariate analysis. Relative to low-risk stone patients, baseline serum TC, TG, and LDL were higher in patients with higher-risk of ASCVD, whereas 24-h urine Na was higher and urine protein amount was lower significantly. When compared to the controls, higher 24-h urine calcium (p=0.049) and uric acid (P<0.001) were found in higher-risk group; whereas lower 24-h urine citrate and serum TT and FT were found in both low- and higher-risk groups. Use of atorvastatin therapy significantly elevated serum TT, FT, 24-h urine citrate, oxalate, and protein levels and decrease 24-hurine uric acid level in higher-risk group.
Conclusion: . kidney stone disease is correlated with obesity (OR=1.231, p=0.044) and serum LDL-C (OR=1.055, P=0.045); and also is associated with lower serum TT and FT levels, which were correlated with Serum TC and LDL significantly as well. Lipitor treatment can improved the risk of urolithiasis by increasing urine citrate and lower urine UA; and increasing serum TT and FT as well. The mechanism about how dyslipidemia to influence the formation of kidney stone disease needs further examination and this study provides the evidence that dyslipidemia is one possible etiology to influence kidney stone disease formation and dyslipidemia treatment by Lipitor could reduce some risk factors for kidney stone disease.