University of Texas Health Science Center at Tyler, Tyler, TX 75708, USA.
Menopause. 2012 Jan;19(1):104-8. doi: 10.1097/gme.0b013e318221be9b.
The aim of this study was to apply the theory of the timing hypothesis to the data presented on the incidence of renal stones in the Women's Health Initiative and the theory of eu-estrogenemia.
The study is a review of the literature on the theory of renal stone formation and postmenopausal women, including data from the Nurses' Health Study and the Women's Health Initiative.
The analysis of the hazard ratios and CIs of renal stones in the Women's Health Initiative shows that specific subgroups are affected. The CIs of the hazard ratios did not overlap 1.0 in the 60- to 64-year-old age group and in women whose time since menopause at study entry was 6 to 10 years. The CIs of all other age groups and years from menopause overlapped 1.0. Hormone therapy use by women described as "current users" at time of entry into the study in the treatment had a hazard ratio of 0.99.
The timing hypothesis of Clarkson (Menopause 14:373-384; 2007) seems to explain the hazard ratio and CI of renal stones in the Women's Health Initiative. A closer analysis of the subgroups of women who had a higher incidence of renal stones suggests that the timing hypothesis may explain the results from the Women's Health Initiative versus previous studies such as the Nurses' Health Study. The CIs of the hazard ratios of the subgroups that did not overlap 1.0 included women 6 to 10 years beyond menopause, those who were aged from 60 to 64 years, and "never users" of hormone therapy. The hazard ratio for renal stones among "current users" in the Women's Health Initiative was 0.99. This analysis suggests that the timing hypothesis may affect estrogen receptor-α-mediated processes in the kidney. Furthermore, Clarkson's work may support the vascular etiology of renal stones.
本研究旨在将定时假说理论应用于妇女健康倡议中肾结石发病率的相关数据，并结合雌-孕激素假说理论进行分析。
本研究对肾结石形成和绝经后妇女的相关文献进行了回顾，包括护士健康研究和妇女健康倡议的数据。
对妇女健康倡议中肾结石的危害比和置信区间（CI）进行分析，结果表明特定亚组受到影响。在 60-64 岁年龄组和绝经后时间为 6-10 年的女性中，危害比的 CI 不重叠 1.0。所有其他年龄组和绝经后时间的 CI 均重叠 1.0。在研究入组时被描述为“当前使用者”的女性中，激素治疗的使用与治疗相关的危害比为 0.99。
Clarkson 的定时假说（Menopause 14:373-384; 2007）似乎可以解释妇女健康倡议中肾结石的危害比和 CI。对肾结石发病率较高的女性亚组进行更详细的分析表明，定时假说可能可以解释妇女健康倡议与护士健康研究等先前研究的结果。危害比 CI 不重叠 1.0 的亚组包括绝经后 6-10 年的女性、年龄在 60-64 岁之间的女性以及从未使用过激素治疗的女性。妇女健康倡议中“当前使用者”的肾结石危害比为 0.99。该分析表明，定时假说可能会影响肾脏中雌激素受体-α介导的过程。此外，Clarkson 的工作可能支持肾结石的血管病因学。
