{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T20:37:18Z","timestamp":1783370238709,"version":"3.54.6"},"reference-count":35,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T00:00:00Z","timestamp":1737676800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82270809"],"award-info":[{"award-number":["82270809"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec015\">\n<jats:title>Background<\/jats:title>\n<jats:p>This study investigates the relationship between sagittal abdominal diameter (SAD), a measure of abdominal obesity, and kidney stone disease (KSD) in the U.S. population. Additionally, it explores potential underlying mechanisms and evaluates the clinical utility of a predictive model.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec016\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Data were collected from 11,671 participants, including 1,136 cases of KSD. Univariate and multivariate logistic regression analyses, dose-response curves, and mediation effect assessments were employed to examine the association between SAD and KSD. A predictive model was developed and validated using calibration curves, receiver operating characteristic (ROC) curves, and clinical decision curves. Additionally, hematological indicators were analyzed to identify potential mediating factors.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec017\">\n<jats:title>Results<\/jats:title>\n<jats:p>SAD showed a strong and positive association with KSD, even after adjusting for confounders such as gender, age, and education. The predictive model demonstrated moderate accuracy (AUC =\u2009 0.661) and clinical utility. Hematological analyses indicated that granulocyte count (GRAN) significantly mediated the relationship between SAD and KSD (P &lt;\u2009 0.001).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec018\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>SAD is a significant risk factor for KSD, underscoring the role of abdominal obesity in kidney stone formation. The predictive model demonstrates potential clinical applications for early risk assessment and management of KSD.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0317717","type":"journal-article","created":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T19:17:19Z","timestamp":1737746239000},"page":"e0317717","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Increased sagittal abdominal diameter is associated with a higher risk of kidney stones"],"prefix":"10.1371","volume":"20","author":[{"given":"Wei","family":"Song","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shugen","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guangchun","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2277-1829","authenticated-orcid":true,"given":"Shang","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,1,24]]},"reference":[{"issue":"9507","key":"pone.0317717.ref001","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1016\/S0140-6736(06)68071-9","article-title":"Kidney stones: pathophysiology and medical management","volume":"367","author":"OW Moe","year":"2006","journal-title":"Lancet"},{"issue":"7","key":"pone.0317717.ref002","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1038\/s41585-020-0332-x","article-title":"Genetics of kidney stone disease","volume":"17","author":"SA Howles","year":"2020","journal-title":"Nat Rev Urol"},{"issue":"3","key":"pone.0317717.ref003","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1016\/j.advnut.2023.03.002","article-title":"Kidney stone prevention","volume":"14","author":"P Peerapen","year":"2023","journal-title":"Adv Nutr"},{"issue":"12","key":"pone.0317717.ref004","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1038\/s41581-020-0320-7","article-title":"Determining the true burden of kidney stone disease","volume":"16","author":"C Thongprayoon","year":"2020","journal-title":"Nat Rev Nephrol"},{"issue":"9","key":"pone.0317717.ref005","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1056\/NEJMoa2209275","article-title":"Hydrochlorothiazide and prevention of kidney-stone recurrence","volume":"388","author":"NA Dhayat","year":"2023","journal-title":"N Engl J Med"},{"key":"pone.0317717.ref006","doi-asserted-by":"crossref","first-page":"16008","DOI":"10.1038\/nrdp.2016.8","article-title":"Kidney stones","volume":"2","author":"SR Khan","year":"2016","journal-title":"Nat Rev Dis Primers"},{"issue":"1","key":"pone.0317717.ref007","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1186\/s12933-020-01095-4","article-title":"Associations between abdominal obesity indices and diabetic complications: Chinese visceral adiposity index and neck circumference","volume":"19","author":"H Wan","year":"2020","journal-title":"Cardiovasc Diabetol"},{"issue":"1","key":"pone.0317717.ref008","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1007\/s00240-021-01288-w","article-title":"Obesity-related indices and its association with kidney stone disease: a cross-sectional and longitudinal cohort study","volume":"50","author":"M-R Lee","year":"2022","journal-title":"Urolithiasis"},{"issue":"4","key":"pone.0317717.ref009","doi-asserted-by":"crossref","first-page":"393","DOI":"10.23736\/S0393-2249.18.03113-2","article-title":"Obesity and kidney stone disease: a systematic review","volume":"70","author":"A Carbone","year":"2018","journal-title":"Minerva Urol Nefrol"},{"issue":"12","key":"pone.0317717.ref010","doi-asserted-by":"crossref","first-page":"810","DOI":"10.3390\/nu8120810","article-title":"Abdominal obesity and lung cancer risk: systematic review and meta-analysis of prospective studies","volume":"8","author":"K Hidayat","year":"2016","journal-title":"Nutrients"},{"issue":"2","key":"pone.0317717.ref011","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1111\/jth.15168","article-title":"Overall and abdominal obesity in relation to venous thromboembolism","volume":"19","author":"S Yuan","year":"2021","journal-title":"J Thromb Haemost"},{"issue":"5","key":"pone.0317717.ref012","first-page":"279","article-title":"Sagittal abdominal diameter as a marker of visceral obesity in older primary care patients","volume":"17","author":"M Saad","year":"2020","journal-title":"J Geriatr Cardiol"},{"issue":"1","key":"pone.0317717.ref013","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1186\/s12889-020-09805-z","article-title":"Sagittal abdominal diameter and its socioeconomic correlates: perspective of sex differences","volume":"21","author":"C Li","year":"2021","journal-title":"BMC Public Health"},{"key":"pone.0317717.ref014","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/j.jad.2024.08.061","article-title":"The impact of anxiety on the risk of kidney stone disease: insights into eGFR-mediated effects","volume":"364","author":"M Gao","year":"2024","journal-title":"J Affect Disord"},{"key":"pone.0317717.ref015","doi-asserted-by":"crossref","first-page":"167915","DOI":"10.1016\/j.scitotenv.2023.167915","article-title":"Serum HDL partially mediates the association between exposure to volatile organic compounds and kidney stones: a nationally representative cross-sectional study from NHANES","volume":"907","author":"M Wu","year":"2024","journal-title":"Sci Total Environ"},{"issue":"1","key":"pone.0317717.ref016","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1007\/s00345-024-05035-9","article-title":"Predictive ability of novel and traditional anthropometric measurement indices for kidney stone disease: a cross-sectional study","volume":"42","author":"G Lv","year":"2024","journal-title":"World J Urol"},{"issue":"1","key":"pone.0317717.ref017","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1186\/s40001-024-01743-5","article-title":"Association of novel anthropometric indices with prevalence of kidney stone disease: a population-based cross-sectional study","volume":"29","author":"X Hu","year":"2024","journal-title":"Eur J Med Res"},{"key":"pone.0317717.ref018","doi-asserted-by":"crossref","first-page":"S88","DOI":"10.1016\/j.nephro.2020.02.003","article-title":"Genetics of kidney stone disease-polygenic meets monogenic","volume":"17S","author":"J Halbritter","year":"2021","journal-title":"Nephrol Ther"},{"issue":"10","key":"pone.0317717.ref019","doi-asserted-by":"crossref","first-page":"1699","DOI":"10.2215\/CJN.11201016","article-title":"Effectiveness of treatment modalities on kidney stone recurrence","volume":"12","author":"AL Zisman","year":"2017","journal-title":"Clin J Am Soc Nephrol"},{"issue":"6","key":"pone.0317717.ref020","doi-asserted-by":"crossref","first-page":"e0130790","DOI":"10.1371\/journal.pone.0130790","article-title":"Polymorphisms in CaSR and CLDN14 genes associated with increased risk of kidney stone disease in patients from the eastern part of India","volume":"10","author":"M Guha","year":"2015","journal-title":"PLoS One"},{"issue":"1","key":"pone.0317717.ref021","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1186\/s12920-022-01265-1","article-title":"The correlation between promoter hypermethylation of VDR, CLDN, and CasR genes and recurrent stone formation","volume":"15","author":"F Khatami","year":"2022","journal-title":"BMC Med Genomics"},{"issue":"17","key":"pone.0317717.ref022","doi-asserted-by":"crossref","first-page":"1608","DOI":"10.1056\/NEJMoa1915925","article-title":"Management of coronary disease in Patients with advanced kidney disease","volume":"382","author":"S Bangalore","year":"2020","journal-title":"N Engl J Med"},{"issue":"6","key":"pone.0317717.ref023","doi-asserted-by":"crossref","first-page":"1545","DOI":"10.1007\/s00345-022-03998-1","article-title":"Relationship between the dietary inflammatory index and kidney stone prevalence","volume":"40","author":"N Liu","year":"2022","journal-title":"World J Urol"},{"issue":"5","key":"pone.0317717.ref024","doi-asserted-by":"crossref","first-page":"978","DOI":"10.3390\/jcm10050978","article-title":"Risk of metabolic syndrome in kidney stone formers: a comparative cohort study with a median follow-up of 19 years","volume":"10","author":"RM Geraghty","year":"2021","journal-title":"J Clin Med"},{"issue":"2","key":"pone.0317717.ref025","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1016\/j.numecd.2020.09.032","article-title":"Sagittal abdominal diameter and waist circumference appear to be equally good as identifiers of cardiometabolic risk","volume":"31","author":"G M\u00f8ller","year":"2021","journal-title":"Nutr Metab Cardiovasc Dis"},{"issue":"1114","key":"pone.0317717.ref026","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1136\/postgradmedj-2017-135332","article-title":"Uric acid stones, clinical manifestations and therapeutic considerations","volume":"94","author":"Q Ma","year":"2018","journal-title":"Postgrad Med J"},{"issue":"6","key":"pone.0317717.ref027","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1111\/bju.14765","article-title":"The status and characteristics of urinary stone composition in China","volume":"125","author":"Z Ye","year":"2020","journal-title":"BJU Int"},{"issue":"6","key":"pone.0317717.ref028","doi-asserted-by":"crossref","first-page":"1787","DOI":"10.1016\/j.juro.2015.07.083","article-title":"Proinflammatory and metabolic changes facilitate renal crystal deposition in an obese mouse model of metabolic syndrome","volume":"194","author":"K Taguchi","year":"2015","journal-title":"J Urol"},{"issue":"5","key":"pone.0317717.ref029","doi-asserted-by":"crossref","first-page":"1042","DOI":"10.1016\/j.kint.2020.01.042","article-title":"Fatty acid-binding protein 4 downregulation drives calcification in the development of kidney stone disease","volume":"97","author":"K Taguchi","year":"2020","journal-title":"Kidney Int"},{"issue":"2","key":"pone.0317717.ref030","doi-asserted-by":"crossref","first-page":"1223","DOI":"10.1152\/physrev.00012.2018","article-title":"The Neutrophil\u2019s role during health and disease","volume":"99","author":"PX Liew","year":"2019","journal-title":"Physiol Rev"},{"key":"pone.0317717.ref031","doi-asserted-by":"crossref","first-page":"566506","DOI":"10.3389\/fphys.2020.566506","article-title":"Mitochondrial dysfunction and kidney stone disease","volume":"11","author":"S Chaiyarit","year":"2020","journal-title":"Front Physiol"},{"key":"pone.0317717.ref032","doi-asserted-by":"crossref","first-page":"113758","DOI":"10.1016\/j.ecoenv.2022.113758","article-title":"The regulatory effect of pulmonary lymphatic drainage on silicosis fibrosis","volume":"241","author":"J Cui","year":"2022","journal-title":"Ecotoxicol Environ Saf"},{"issue":"11","key":"pone.0317717.ref033","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1007\/s11883-017-0678-6","article-title":"Oxidative stress in Atherosclerosis","volume":"19","author":"AJ Kattoor","year":"2017","journal-title":"Curr Atheroscler Rep"},{"issue":"2","key":"pone.0317717.ref034","doi-asserted-by":"crossref","first-page":"143","DOI":"10.2174\/1381612826666200728144605","article-title":"Natural products and extracts as Xantine oxidase inhibitors - a hope for Gout disease?","volume":"27","author":"IE Orhan","year":"2021","journal-title":"Curr Pharm Des"},{"issue":"6","key":"pone.0317717.ref035","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1038\/s41581-020-00392-1","article-title":"Randall\u2019s plaque and calcium oxalate stone formation: role for immunity and inflammation","volume":"17","author":"SR Khan","year":"2021","journal-title":"Nat Rev Nephrol"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0317717","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T19:17:30Z","timestamp":1737746250000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0317717"}},"subtitle":[],"editor":[{"given":"Li","family":"Yang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,1,24]]},"references-count":35,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1,24]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0317717","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,24]]}}}