Huang Ben-Shian, Chang Wen-Hsun, Wang Kuan-Chin, Huang Nicole, Guo Chao-Yu, Chou Yiing-Jen, Huang Hsin-Yi, Chen Tzeng-Ji, Lee Wen-Ling, Wang Peng-Hui
Department of Obstetrics and Gynecology, Yang-Ming University Hospital, Ilan 260, Taiwan.
Department of Obstetrics and Gynecology, National Yang-Ming University, Taipei 112, Taiwan.
Int J Mol Sci. 2016 Jul 7;17(7):1079. doi: 10.3390/ijms17071079.
This study was conducted to determine the risk of chronic kidney disease (CKD) among women with endometriosis in Taiwan. We conducted a retrospective cohort study using the National Health Insurance Research Database of Taiwan. A total of 27,973 women with a diagnosis of endometriosis and 27,973 multivariable-matched controls (1:1) from 2000 to 2010 were selected. Cox regression and computed hazard ratios (HR) with 95% confidence intervals (95% CI) were used to determine the risk of CKD among women with endometriosis. The incidence rates (IR, per 10,000 person-years) of CKD among women with and without endometriosis were 4.64 and 7.01, respectively, with a significantly decreased risk of CKD (crude HR 0.65, 95% CI 0.53-0.81; adjusted HR 0.69, 95% CI 0.56-0.86) among women with endometriosis. The IR of CKD progressively increased with age, but the trend of lower CKD risk among women with endometriosis was consistent. However, the lower risk of CKD in women with endometriosis was no longer statistically significant after adjusting for menopausal status (adjusted HR 0.85, 95% CI 0.65-1.10). The results suggest that endometriosis is inversely associated with CKD, but this effect was mediated by menopause. The possible mechanism of this association is worthy of further evaluation.
本研究旨在确定台湾子宫内膜异位症女性患慢性肾脏病（CKD）的风险。我们利用台湾国民健康保险研究数据库进行了一项回顾性队列研究。选取了2000年至2010年间共27,973例诊断为子宫内膜异位症的女性和27,973例多变量匹配对照（1:1）。采用Cox回归分析并计算风险比（HR）及95%置信区间（95%CI），以确定子宫内膜异位症女性患CKD的风险。有和没有子宫内膜异位症的女性CKD发病率（IR，每10,000人年）分别为4.64和7.01，子宫内膜异位症女性患CKD的风险显著降低（粗HR 0.65，95%CI 0.53 - 0.81；调整后HR 0.69，95%CI 0.56 - 0.86）。CKD的IR随年龄逐渐增加，但子宫内膜异位症女性患CKD风险较低的趋势是一致的。然而，在调整绝经状态后，子宫内膜异位症女性患CKD的较低风险不再具有统计学意义（调整后HR 0.85，95%CI 0.65 - 1.10）。结果表明，子宫内膜异位症与CKD呈负相关，但这种效应是由绝经介导的。这种关联的可能机制值得进一步评估。
