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Relevance of Mediterranean diet and glucose metabolism for nephrolithiasis in obese subjects

Laura Soldati1*, Simona Bertoli2, Annalisa Terranegra1, Caterina Brasacchio1, Alessandra Mingione1, Elena Dogliotti1, Benedetta Raspini1, Alessandro Leone2, Francesca Frau1, Laila Vignati2, Angela Spadafranca2, Giuseppe Vezzoli3, Daniele Cusi1 and Alberto Battezzati2

Author Affiliations

1 Department of Health Sciences, University of Milan, Milano, Italy

2 International Center for the Assessment of Nutritional Status (ICANS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, Milano, Italy

3 Nephrology and Dialysis Unit, San Raffaele Hospital, Milan, Italy

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Journal of Translational Medicine 2014, 12:34  doi:10.1186/1479-5876-12-34

Published: 6 February 2014



Nephrolithiasis is more frequent and severe in obese patients from different western nations. This may be supported by higher calcium, urate, oxalate excretion in obese stone formers. Except these parameters, clinical characteristics of obese stone formers were not extensively explored.


In the present paper we studied the relationship between obesity and its metabolic correlates and nephrolithiasis.

Materials and methods

We studied 478 Caucasian subjects having BMI ≥ 25 kg/m2. The presence of nephrolithiasis, hypertension, diabetes mellitus and metabolic syndrome were noted. They underwent measurements of anthropometry (BMI and waist circumference, body composition), serum variables (fasting glucose, serum lipids and serum enzymes) and Mediterranean diet (MedDiet) nutritional questionnaire.


45 (9.4%) participants were stone formers. Subjects with high serum concentrations of triglycerides (≥150 mg/dl), fasting glucose (> 100 mg/dl) and AST (>30 U/I in F or >40 U/I in M) were more frequent among stone formers than non-stone formers.

Multinomial logistic regression confirmed that kidney stone production was associated with high fasting glucose (OR = 2.6, 95% CI 1.2-5.2, P = 0.011), AST (OR = 4.3, 95% CI 1.1-16.7, P = 0.033) and triglycerides (OR = 2.7, 95% CI 1.3-5.7, P = 0.01).

MedDiet score was not different in stone formers and non-stone formers. However, stone formers had a lower consumption frequency of olive oil and nuts, and higher consumption frequency of wine compared with non-stone formers.


Overweight and obese stone formers may have a defect in glucose metabolism and a potential liver damage. Some foods typical of Mediterranean diet may protect against nephrolithiasis.