Widjanarko Nicolas Daniel, Iskandar Archie Fontana, Suryatenggara Felicia Grizelda, Sylfiasari Rosalia, Leonardo Leonardo
Pertamina Dumai Hospital, Dumai, Riau, Indonesia.
Cimacan Regional General Hospital, Cianjur, West Java, Indonesia.
J Hum Reprod Sci. 2024 Apr-Jun;17(2):68-80. doi: 10.4103/jhrs.jhrs_31_24. Epub 2024 May 28.
Polycystic ovarian syndrome (PCOS) is a gynaecological problem affecting women within reproductive age, accompanied by several metabolic anomalies, thus leading to alteration in kidney function and hyperuricaemia. Due to the high prevalence of cardiometabolic factors in PCOS, there is a need to anticipate an increased number of kidney impairments amongst these women.
This review aims to investigate the potential link between PCOS, impaired kidney function, and elevated uric acid levels. By elucidating this association, we hope to provide clinicians with a tool to stratify the risk of kidney disease in women diagnosed with PCOS, based on readily available kidney function parameters.
The recommendations used for the analysis were outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. Subsequently, eligible studies were identified using several databases (MEDLINE, ProQuest and EBSCOhost) between 1996 and 2022, with a total of 13 studies included. Serum uric acid, serum creatinine, as well as estimated glomerular filtration rate (eGFR) were evaluated as the outcome of interest. Quality assessment for cohort, case-control and cross-sectional studies was conducted utilising the Newcastle-Ottawa Scale, while Review Manager 5.4 was utilised for meta-analysis.
Uric acid was significantly higher in women with PCOS (mean difference [MD] = 0.70, 95% confidence interval [CI] [0.45-0.95], < 0.00001). Meanwhile, serum creatinine and eGFR were statistically similar in each group (MD = 0.08, 95% CI [-0.05-0.21], = 0.22 and MD = 3.54, 95% CI [-4.53-11.61], = 0.39, respectively).
This review showed that PCOS was significantly associated with elevated uric acid. However, no significant difference was found between eGFR and creatinine levels compared to healthy controls. Routine uric acid assessment in PCOS patients is recommended as a simple tool for risk stratification.
No body mass index (BMI) subgroup analysis was done due to limited BMI reporting in our included studies. Quantitative analysis of all kidney function parameters was also limited by sparse data on urea and albumin.
CRD42023410092 (02 April 2023).
多囊卵巢综合征（PCOS）是一种影响育龄女性的妇科问题，伴有多种代谢异常，进而导致肾功能改变和高尿酸血症。由于PCOS中心血管代谢因素的高患病率，有必要预计这些女性中肾功能损害的数量会增加。
本综述旨在研究PCOS、肾功能损害和尿酸水平升高之间的潜在联系。通过阐明这种关联，我们希望为临床医生提供一种工具，以便根据易于获得的肾功能参数对诊断为PCOS的女性患肾病的风险进行分层。
分析所使用的建议在《系统评价和Meta分析的首选报告项目2020指南》中有所概述。随后，在1996年至2022年期间使用多个数据库（MEDLINE、ProQuest和EBSCOhost）识别符合条件的研究，共纳入13项研究。血清尿酸、血清肌酐以及估计肾小球滤过率（eGFR）被评估为感兴趣的结果。使用纽卡斯尔-渥太华量表对队列研究、病例对照研究和横断面研究进行质量评估，同时使用Review Manager 5.4进行Meta分析。
PCOS女性的尿酸显著更高（平均差[MD]=0.70，95%置信区间[CI][0.45 - 0.95]，P<0.00001）。同时，每组的血清肌酐和eGFR在统计学上相似（MD = 0.08，95% CI [-0.05 - 0.21]，P = 0.22；MD = 3.54，95% CI [-4.53 - 11.61]，P = 0.39）。
本综述表明PCOS与尿酸升高显著相关。然而，与健康对照组相比，eGFR和肌酐水平未发现显著差异。建议对PCOS患者进行常规尿酸评估，作为风险分层的简单工具。
由于我们纳入的研究中BMI报告有限，未进行BMI亚组分析。所有肾功能参数的定量分析也受到尿素和白蛋白数据稀少的限制。
PROSPERO注册号：CRD42023410092（2023年4月2日）。
