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绝经后妇女生殖寿命持续时间与慢性肾脏病的关联。

Association of Reproductive Lifespan Duration and Chronic Kidney Disease in Postmenopausal Women.

机构信息

Department of Internal Medicine, College of Medicine, Institute of Kidney Disease, Yonsei University, Seoul, Republic of Korea.

Division of Nephrology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.

出版信息

Mayo Clin Proc. 2020 Dec;95(12):2621-2632. doi: 10.1016/j.mayocp.2020.02.034. Epub 2020 Nov 6.

Abstract

OBJECTIVE

To investigate the relationship between endogenous estrogen exposure and renal function, the association of female reproductive life span duration (RLD) and chronic kidney disease (CKD) was analyzed in postmenopausal women.

PATIENTS AND METHODS

Data were retrieved from the Korean Genome and Epidemiology Study, which was constructed from May 1, 2001, through December 25, 2017. A total of 50,338 and 3155 postmenopausal women were each included in the cross-sectional and longitudinal analyses. The RLD was determined by subtracting the age at menarche from the age at menopause. Participants were grouped into RLD quartiles. Participants with estimated glomerular filtration rates less than 60 mL/min/1.73 m were regarded to have CKD.

RESULTS

In the cross-sectional analysis, mean ± SD age and estimated glomerular filtration rate were 56.3±4.9 years and 93.1±13.6 mL/min/1.73 m, respectively. Mean ± SD RLD was 34.2±4.0 years. A total of 765 of 50,338 (1.52%) women were found to have CKD. Logistic regression analysis revealed that the odds ratio for CKD was lower in groups with longer RLDs as compared with the shortest RLD group. In longitudinal analysis, postmenopausal women with normal kidney function were followed up for 9.7 years and incident CKD occurred in 221 of 3155 (7.00%) participants. Cox analysis revealed that the risk for CKD development was significantly lower in longer RLD groups. This finding was significant even after adjustments for confounding factors.

CONCLUSION

The risk for CKD was lower in women with longer RLDs. The amount of endogenous estrogen exposure could be a determining factor for renal function in postmenopausal women.

摘要

目的

探讨内源性雌激素暴露与肾功能之间的关系,分析绝经后女性的生殖寿命(RLD)与慢性肾脏病(CKD)的相关性。

方法

本研究数据来自韩国基因组与流行病学研究,该研究于 2001 年 5 月 1 日至 2017 年 12 月 25 日构建。共有 50338 名和 3155 名绝经后女性分别纳入横断面和纵向分析。RLD 通过从初潮年龄中减去绝经年龄来确定。参与者被分为 RLD 四分位组。估计肾小球滤过率(eGFR)<60mL/min/1.73m2 的参与者被认为患有 CKD。

结果

在横断面分析中,平均年龄(SD)和 eGFR 分别为 56.3±4.9 岁和 93.1±13.6mL/min/1.73m2。平均 RLD(SD)为 34.2±4.0 岁。50338 名女性中共有 765 名(1.52%)患有 CKD。Logistic 回归分析显示,与 RLD 最短组相比,RLD 较长组的 CKD 患病比值比(OR)较低。在纵向分析中,肾功能正常的绝经后女性随访 9.7 年,3155 名参与者中有 221 名(7.00%)发生 CKD。Cox 分析显示,RLD 较长组发生 CKD 的风险显著降低。即使在调整了混杂因素后,这种发现仍然具有统计学意义。

结论

RLD 较长的女性发生 CKD 的风险较低。内源性雌激素暴露量可能是绝经后女性肾功能的一个决定因素。

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