Üriner Sistem Taşı Ouşturan ve Oluşturmayan Primer Hiperparatiroidili Hastaların Bağırsak Mikrobiyotasındaki Mikroorganizmların Karşılaştırılması
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Münasib M. Comparison of Microorganisms in the Intestinal Microbiota of Patients with Primary Hyperparathyroidism with and without Urinary System Stones. Hacettepe University Faculty of Medicine, Department of Urology. Thesis in Urology. Ankara 2023. Hypercalciuria is one of the most important predisposing risk factors in stone formation. Primary Hyperparathyroidism is a common endocrine disorder characterized by hypercalciuria and increased parathormone level. Symptomatic urinary system stone disease is seen in 10-20% of these patients. Although hypercalcemia and hypercalciuria were detected in 24-hour urine analysis, the mechanism of why urinary system stones occur only in a group of primary hyperparathyroidism patients is still not fully understood. Recently, many studies have shown that differences in intestinal microbiota may play a role in urinary tract stone disease. In this study, it was aimed to compare the intestinal microbiota of Primary Hyperparathyroidism patients with and without urinary system stones, to determine the microbiota diversity between the two groups and to reveal the relationship between the diversity in the intestinal microbiota and the formation of kidney stones. Among the patients diagnosed with Primary Hyperparathyroidism between October 2021 and October 2022, 15 patients with urinary system stones and 25 patients without urinary system stones were included in the study. Patients who used antibiotics regularly in the last 3 months, had bariatric surgery, patients with inflammatory bowel disease, GIS cancers, cystic fibrosis, celiac disease and congenital GUS anomalies, as well as patients with Secondary or Tertiary Hyperparathyroidism were excluded from the study. Microorganisms in the gut microbiota of 40 patients were determined by metagenome study. Microorganisms were identified at the level of 9 filum, 14 classes, 23 orders and 37 families in two groups. When the gut microbiota of the two groups were compared, although there was no statistically significant difference at the filum level, Clostridia (p=0.024) at the class level, Lachnospirales (p=0.015) and the “Others” (p=0.015) group at the order level, Lachnospiraceae (p=0.015), Bacteroidaceae (p=0.030) and “Others” (p=0.011) at the family level were found statistically significant more in the stone group.