目的:我們以配對病例對照研究來探討原住民之飲用水水源、水份攝取及飲食習慣與尿路結石發生危險性之相關性。材料與方法: 病例組為58名30-64歲之原住民尿路結石發生病患。對照組為104名經年齡、性別及居住鄉鎮各別配對之社區健康對照。飲水及飲食的暴露情形係以結構式問卷訪談來蒐集,尿路結石發生危險性則以配對對數迴歸來估計。結果:單因子分析顯示,身體質量指數、家庭月收入、一等親尿結石病史、飲水量、肉類及蔬果之攝取,均與尿路結石罹病危險性有顯著相關存在。在調整家庭月收入、身體質量指數、ㄧ等親病史及蔬果類食物之攝取頻率的影響後低飲水量、動物性蛋白及動物內臟高攝取頻率者均有顯著偏高之罹病危險性。結論:降低動物性蛋白及增加水分的攝取,應可有效地降低罹患尿路結石地危險性。(慈濟醫學 200; 15:155-162)
Objective: We carried out a matched case-control study to explore the relationships between intake and source of drinking water, dietary habits and risk of urinary stones in eastern Taiwan aborigines. Materials and Methods: The case group included aborigines between 30 and 64 years old who had urinary stones. Two community controls were randomly selected from a pool of eligible subjects matched to the index case by age, sex, and township of residence. There were 58 incident cases and 104 matched controls in the study. Information associated with personal characteristics, fluid intake and dietary habits of each study subjects was obtained via a structured-questionnaire interview. Univariate- and multivariate conditional logistic regression analyses were used to evaluate the relative risk of developing urinary stones. Results: In univariate analyses, we found that body mass index (BMI), monthly family income, family history of urinary stones in first degree relatives, and consumption of drinking water, red meat, animal protein, green leafy vegetables and fruits were significantly associated with risk of developing urinary stones. After adjustment for BMI, monthly family income, family history of urinary stones in first degree relatives, and consumption of green leafy vegetables and fruits, the multivariate-adjusted odds ratio (OR) for subjects who drank less than 1.0 liter of water was significantly elevated compared to subjects who drank more than 1.8 liters of water. There was a significant inverse dose-response relationship between daily intake of drinking water and risk of urinary stones. Subjects with higher consumption of animal protein and animal viscera also had significantly elevated risks of developing urinary stones. Conclusions: Reducing consumption of meat and animal proteins and increasing water intake can lower the risk of developing urinary stones. (Tzu Chi Med J 2003; 15:155-162)