■尿石症(美元)历来影响老年男性,但是研究表明,最近女性人数有所增加,导致几乎相同的性别发病率。美元发病率每10年翻一番,随着儿童不成比例的增加,青春期,年轻成人(AYA)妇女。妇女的美元结石成分通常是磷灰石(磷酸钙),在较高的尿液pH中形成,低尿柠檬酸盐,和大量的尿尿酸,而男性会产生更多的草酸钙结石。这种流行病学趋势的原因尚不清楚。
■这个角度用加拿大省和北美机构的数据展示了美元的范围,对这些发现的解释,并提供了减少这一趋势的潜在解决方案。我们描述了美元的经济影响。
■在安大略省,美元的整体手术干预措施显着增加了46%。发病率从2002年的47.0/100,000上升到2016年的68.7/100,000人口。在一个单一的美国机构中,从2015年到2019年,美元年度独特患者总数从10,612增加到17,706,而持有美元的女性比例远高于预期。在10-17岁的患者中,50.1%是女孩;18-34岁年龄组为57.5%,35-44岁年龄组为53.6%。肥胖的作用,饮食,荷尔蒙,环境因素,感染,和抗生素,以及经济影响,正在讨论。
■我们确认了女性美元的显着增长。我们为这种性别差异提供了潜在的解释,包括微生物学和病理生理学方面。我们还概述了创新的解决方案-可能需要超越典型的预防和治疗建议的步骤。
UNASSIGNED: Urinary stone disease (USD) historically has affected older men, but studies suggest recent increases in women, leading to a near identical sex incidence ratio. USD incidence has doubled every 10 years, with disproportionate increases amongst children, adolescent, and young adult (AYA) women. USD stone composition in women is frequently apatite (calcium phosphate), which forms in a higher urine pH, low urinary citrate, and an abundance of urinary uric acid, while men produce more calcium oxalate stones. The reasons for this epidemiological trend are unknown.
UNASSIGNED: This perspective presents the extent of USD with data from a Canadian Province and a North American institution, explanations for these findings and offers potential solutions to decrease this trend. We describe the economic impact of USD.
UNASSIGNED: There was a significant increase of 46% in overall surgical interventions for USD in Ontario. The incidence rose from 47.0/100,000 in 2002 to 68.7/100,000 population in 2016. In a single United States institution, the overall USD annual unique patient count rose from 10,612 to 17,706 from 2015 to 2019, and the proportion of women with USD was much higher than expected. In the 10-17-year-old patients, 50.1% were girls; with 57.5% in the 18-34 age group and 53.6% in the 35-44 age group. The roles of obesity, diet, hormones, environmental factors, infections, and antibiotics, as well as the economic impact, are discussed.
UNASSIGNED: We confirm the significant increase in USD among women. We offer potential explanations for this sex disparity, including microbiological and pathophysiological aspects. We also outline innovative solutions - that may require steps beyond typical preventive and treatment recommendations.