Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway.
Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Clin Endocrinol (Oxf). 2020 Nov;93(5):590-597. doi: 10.1111/cen.14284. Epub 2020 Jul 26.
Results of studies focusing on chronic kidney disease (CKD) among women with polycystic ovary syndrome (PCOS) are insufficient and controversial. This study aimed to evaluate the incidence rate of CKD in women with PCOS, compared to a control group of healthy women.
This study was a population-based cohort study conducted from among 1460 reproductive-age women including 156 women with PCOS and 1304 controls. Incidence rates per 1000 person-years of follow-up were calculated for PCOS and control groups. Cox proportional hazards regression with age as the time-scale was used to estimate hazard ratios (HR) and 95% confidence intervals for developing CKD in relation to PCOS in both univariable and multivariable models.
During a median follow-up of 12.9 years, 330 new cases of CKD were identified, including 25 PCOS women (14.8 per 1000 person-years; 95% CI, 10-22) and 305 healthy controls (21.5 per 1000 person-years; 95% CI, 19.2-24.1). The results of the Cox model showed that the risk of CKD among women with PCOS and healthy women is comparable and women with PCOS did not have a higher risk of developing CKD compared to healthy women (unadjusted HR: 0.883; 95% CI: 0.587-1.328; P = .551). The results remained unchanged after adjustment for potential confounders of smoking status, BMI, hypertension and diabetes at baseline and follow-up of study (multiple adjusted HR: 0.911; 95% CI: 0.600-1.383; P = .661).
Our population-based study with a long-term follow-up period showed that the risk of CKD in PCOS patients was similar to the general female population. Large studies, with long-term follow-up and more diverse phenotypes, are needed to confirm the findings.
针对多囊卵巢综合征（PCOS）女性慢性肾脏病（CKD）的研究结果尚不足且存在争议。本研究旨在评估多囊卵巢综合征女性的 CKD 发病率，并与健康女性对照组进行比较。
本研究是一项基于人群的队列研究，纳入了 1460 名育龄期女性，其中包括 156 名 PCOS 女性和 1304 名对照者。计算了 PCOS 组和对照组的每 1000 人年随访的发病率。采用 Cox 比例风险回归，以年龄作为时间尺度，分别在单变量和多变量模型中估计 PCOS 与 CKD 之间的风险比（HR）和 95%置信区间。
在中位随访 12.9 年期间，共确定了 330 例新的 CKD 病例，其中包括 25 名 PCOS 女性（14.8 例/1000 人年；95%CI，10-22）和 305 名健康对照者（21.5 例/1000 人年；95%CI，19.2-24.1）。Cox 模型的结果表明，PCOS 女性与健康女性的 CKD 风险相当，且 PCOS 女性发生 CKD 的风险并不高于健康女性（未校正 HR：0.883；95%CI：0.587-1.328；P=0.551）。在校正吸烟状况、基线和研究随访时的 BMI、高血压和糖尿病等潜在混杂因素后，结果仍然不变（多变量校正 HR：0.911；95%CI：0.600-1.383；P=0.661）。
本基于人群的研究具有长期随访期，结果表明 PCOS 患者的 CKD 风险与一般女性人群相似。需要更大规模、长期随访和更多样化表型的研究来证实这一发现。
