UroToday.com - No disease is local! As we continue to investigate the origins of illness, we are learning that most surgical disease, which is invariably localized, is the effect of a multifactorial cause. In urolithiasis, we are now beginning to understand that there is an association, between obesity and urolithiasis (i.e. the metabolic syndrome). The metabolic syndrome also includes hyperlipidemia, type 2 diabetes, and hypertension.