Kidney stone disease (KSD) is a growing global health concern, with obesity (OB) as a major risk factor linked to metabolic dysfunction and chronic inflammation. Although the common method for evaluating OB is body mass index (BMI), it is not specific enough when it comes to reflecting visceral fat. The perirenal fat thickness (PFT) might present better predictive capabilities. The goal of this research was to assess the clinical usefulness of PFT in the diagnosis of KSD and to clarify the molecular mechanisms connecting OB to KSD.
Analysis was carried out on a retrospective cohort of 413 patients (265 having KSD and 148 controls). Abdominal computed tomography was used to measure PFT. Three machine-learning methods, weighted gene co-expression network analysis, and differential expression analysis were used to evaluate gene expression data for key gene identification. Internal and external datasets were used to develop and validate a diagnostic nomogram. Also, pathway enrichment analysis was carried out.
KSD patients exhibited greater PFT versus controls, with significantly enhanced diagnostic accuracy compared to BMI. Multivariate analysis confirmed PFT as an independent predictor of KSD (OR = 1.20, P < 0.001). Eight genes that are differentially expressed in relation to OB were identified, among which FAM20A and DHRS9 were found to be central hub genes. The nomogram exhibited a high level of predictive accuracy. Analysis of enrichment pointed to the IL-6/JAK/STAT3 and TNF-α/NF-κB signaling pathways in the connection between perirenal fat and KSD.
PFT serves as a practical and dependable marker for the risk of KSD. It is superior to BMI and can be conveniently incorporated into routine clinical practice. Stone formation may be linked to perirenal fat by FAM20A and DHRS9 via inflammatory pathways, which provides potential targets for the management of OB-related KSD.
Lipids in health and disease. 2025 Aug 29*** epublish ***
Kaifeng Mao, Xiang Xu, Yifei Zhu, Fenwang Lin, Zhenquan Lu, Bingfeng Luo, Genggeng Wei, Yuan Yuan, Sucai Liao, Yaping Xing, Wenyan Huang, Ruidong Ji, Yige Pan, Zhenda Li, Junsheng Ye, Lin Xiong
Division of Urology, Department of Surgery, The University of Hong Kong- Shenzhen Hospital, Shenzhen City, Guangdong Province, China., Department of Kidney Transplantation, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua Medicine, Tsinghua University, Beijing, 102218, China., Department of Nursing, The University of Hong Kong-Shenzhen Hospital, Shenzhen City, Guangdong Province, China., Department of Thoracic Surgery, the University of Hong Kong-Shenzhen Hospital, Shenzhen City, Guangdong Province, China., Department of Kidney Transplantation, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua Medicine, Tsinghua University, Beijing, 102218, China. ., Division of Urology, Department of Surgery, The University of Hong Kong- Shenzhen Hospital, Shenzhen City, Guangdong Province, China. .