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Objectives <p>This study analyzed the association between serum pyridoxal 5'-phosphate (PLP) levels and kidney stones (KS) risk.</p> Methods <p>Baseline data of participants were obtained from the 2007–2008 and 2009–2010 cycles of the National Health and Nutrition Examination Survey&#xa0;database. After screening, the participants were divided into KS&#xa0;and non-KS&#xa0;groups. Serum PLP levels were categorized into quartiles (Q1–4) from the lowest to the highest. Weighted multivariate logistic regression, restricted cubic spline (RCS), and subgroup analyses were conducted to explore the correlation between serum PLP and KS&#xa0;risk. RCS analysis was used to examine the associations between immunoinflammatory markers, including C-reactive protein, lymphocytes, platelets, and neutrophils, with KS&#xa0;risk and serum PLP levels. Mediation analysis was performed to study the mediating effect of immunoinflammatory markers on the association between serum PLP and KS&#xa0;risk. Network pharmacology was used to analyze potential targets between PLP and KS.</p> Results <p>The study finally included 870 participants with KS&#xa0;and 8721 non-KS. Weighted multivariate logistic regression analysis suggested that participants with Q4 PLP level had a lower KS&#xa0;risk than those with Q1 level (odds ratio: 0.66, 95% confidence interval: 0.46–0.96). The RCS indicated a nonlinear negative correlation between serum PLP and KS&#xa0;risk (<i>P</i> nonlinear = 0.0074). Furthermore, subgroup analyses identified that this protective association was strongest and most significant in a specific demographic: individuals with a body mass index (BMI) of 25–29.9&#xa0;kg/m<sup>2</sup>, without diabetes, and without hypertension. RCS revealed a nonlinear negative correlation between neutrophil count and serum PLP levels and a nonlinear positive correlation between neutrophil count and KS&#xa0;risk. Mediation analysis revealed that neutrophils mediated the association between serum PLP and KS risk, with a mediating effect of 5.61% (<i>P</i> = 0.004). Network pharmacology suggested that PLP may affect KS through pathways, including the HIF and chemokine signaling pathways.</p> Conclusions <p>Among participants with a BMI of 25–29.9, without diabetes or hypertension, higher serum PLP levels were associated with a lower KS risk. Inflammation may affect the association between PLP and KS risk.</p>

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Association between serum pyridoxal 5'-phosphate and kidney stone risk: neutrophil count as a partial mediator

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月23日

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  • Di Chen,
  • Wenju Fan,
  • Qiufeng Zhou,
  • Chengxin Li,
  • Pengnan Hu,
  • GaoMeng Wei

摘要

Objectives

This study analyzed the association between serum pyridoxal 5'-phosphate (PLP) levels and kidney stones (KS) risk.

Methods

Baseline data of participants were obtained from the 2007–2008 and 2009–2010 cycles of the National Health and Nutrition Examination Survey database. After screening, the participants were divided into KS and non-KS groups. Serum PLP levels were categorized into quartiles (Q1–4) from the lowest to the highest. Weighted multivariate logistic regression, restricted cubic spline (RCS), and subgroup analyses were conducted to explore the correlation between serum PLP and KS risk. RCS analysis was used to examine the associations between immunoinflammatory markers, including C-reactive protein, lymphocytes, platelets, and neutrophils, with KS risk and serum PLP levels. Mediation analysis was performed to study the mediating effect of immunoinflammatory markers on the association between serum PLP and KS risk. Network pharmacology was used to analyze potential targets between PLP and KS.

Results

The study finally included 870 participants with KS and 8721 non-KS. Weighted multivariate logistic regression analysis suggested that participants with Q4 PLP level had a lower KS risk than those with Q1 level (odds ratio: 0.66, 95% confidence interval: 0.46–0.96). The RCS indicated a nonlinear negative correlation between serum PLP and KS risk (P nonlinear = 0.0074). Furthermore, subgroup analyses identified that this protective association was strongest and most significant in a specific demographic: individuals with a body mass index (BMI) of 25–29.9 kg/m2, without diabetes, and without hypertension. RCS revealed a nonlinear negative correlation between neutrophil count and serum PLP levels and a nonlinear positive correlation between neutrophil count and KS risk. Mediation analysis revealed that neutrophils mediated the association between serum PLP and KS risk, with a mediating effect of 5.61% (P = 0.004). Network pharmacology suggested that PLP may affect KS through pathways, including the HIF and chemokine signaling pathways.

Conclusions

Among participants with a BMI of 25–29.9, without diabetes or hypertension, higher serum PLP levels were associated with a lower KS risk. Inflammation may affect the association between PLP and KS risk.