Endogenous estrogen exposure and chronic kidney disease; a 15-year prospective cohort study
Abstract Background Despite strong evidence demonstrating the role of estrogen as a protective factor for kidney function in women, limited data are available regarding the influence of endogenous estrogen exposure (EEE) on chronic kidney disease (CKD). The present study aimed to assess the incidenc...
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doaj-9a8f4c4b5c214d459258d7c3e0fb374b2021-08-08T11:03:16ZengBMCBMC Endocrine Disorders1472-68232021-08-012111810.1186/s12902-021-00817-3Endogenous estrogen exposure and chronic kidney disease; a 15-year prospective cohort studyMaryam Farahmand0Fahimeh Ramezani Tehrani1Davood Khalili2Leila Cheraghi3Fereidoun Azizi4Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical SciencesReproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical SciencesPrevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical SciencesDepartment of Epidemiology and Biostatistics, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical SciencesEndocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical SciencesAbstract Background Despite strong evidence demonstrating the role of estrogen as a protective factor for kidney function in women, limited data are available regarding the influence of endogenous estrogen exposure (EEE) on chronic kidney disease (CKD). The present study aimed to assess the incidence of CKD in women with various levels of EEE. Methods In a prospective population-based study over a 15-year follow-up, a total of 3043 eligible women aged 30–70 years, participating in Tehran-Lipid and Glucose-Study were recruited and divided into two groups (EEE < 11 and EEE ≥ 11 years). EEE calculated based on age at menarche, age at menopause, number and duration of pregnancies, lactation, and duration of oral contraceptive use after excluding the progesterone dominant phase of the menstrual cycle. Cox’s proportional hazards model was applied to estimate the hazard ratio of CKD between the study groups, after adjusting for confounders. Results The total cumulative incidence rate of CKD was 50.1 per 1000 person years; 95% CI: 47.7–52.6); this was 53.9 (95%CI, 50.2–57.8) and 47.1 (95%CI, 44.0–50.4) per 1000 person years in women with EEE < 11 and EEE ≥ 11 years, respectively. The model adjusted for age, BMI, smoking, hypertension, and diabetes showed that the hazard ratio (HR) of incidence CKD in women with EEE < 11 compare to those with EEE ≥ 11 years in the subgroup of women aged< 45 years was 2.66(95% CI, 2.2, 3.2), whereas, in the subgroup aged ≥45 years, it was 1.22 (95% CI, 1.04, 1.4). Conclusion This study shows a higher HR of CKD incidence in women with low EEE levels in their later life. Screening of these women for CKD may be recommended.https://doi.org/10.1186/s12902-021-00817-3Endogenous estrogen exposureChronic kidney disease (CKD)MenopauseMenarcheEstimated glomerular filtration rate (eGFR) |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Maryam Farahmand Fahimeh Ramezani Tehrani Davood Khalili Leila Cheraghi Fereidoun Azizi |
spellingShingle |
Maryam Farahmand Fahimeh Ramezani Tehrani Davood Khalili Leila Cheraghi Fereidoun Azizi Endogenous estrogen exposure and chronic kidney disease; a 15-year prospective cohort study BMC Endocrine Disorders Endogenous estrogen exposure Chronic kidney disease (CKD) Menopause Menarche Estimated glomerular filtration rate (eGFR) |
author_facet |
Maryam Farahmand Fahimeh Ramezani Tehrani Davood Khalili Leila Cheraghi Fereidoun Azizi |
author_sort |
Maryam Farahmand |
title |
Endogenous estrogen exposure and chronic kidney disease; a 15-year prospective cohort study |
title_short |
Endogenous estrogen exposure and chronic kidney disease; a 15-year prospective cohort study |
title_full |
Endogenous estrogen exposure and chronic kidney disease; a 15-year prospective cohort study |
title_fullStr |
Endogenous estrogen exposure and chronic kidney disease; a 15-year prospective cohort study |
title_full_unstemmed |
Endogenous estrogen exposure and chronic kidney disease; a 15-year prospective cohort study |
title_sort |
endogenous estrogen exposure and chronic kidney disease; a 15-year prospective cohort study |
publisher |
BMC |
series |
BMC Endocrine Disorders |
issn |
1472-6823 |
publishDate |
2021-08-01 |
description |
Abstract Background Despite strong evidence demonstrating the role of estrogen as a protective factor for kidney function in women, limited data are available regarding the influence of endogenous estrogen exposure (EEE) on chronic kidney disease (CKD). The present study aimed to assess the incidence of CKD in women with various levels of EEE. Methods In a prospective population-based study over a 15-year follow-up, a total of 3043 eligible women aged 30–70 years, participating in Tehran-Lipid and Glucose-Study were recruited and divided into two groups (EEE < 11 and EEE ≥ 11 years). EEE calculated based on age at menarche, age at menopause, number and duration of pregnancies, lactation, and duration of oral contraceptive use after excluding the progesterone dominant phase of the menstrual cycle. Cox’s proportional hazards model was applied to estimate the hazard ratio of CKD between the study groups, after adjusting for confounders. Results The total cumulative incidence rate of CKD was 50.1 per 1000 person years; 95% CI: 47.7–52.6); this was 53.9 (95%CI, 50.2–57.8) and 47.1 (95%CI, 44.0–50.4) per 1000 person years in women with EEE < 11 and EEE ≥ 11 years, respectively. The model adjusted for age, BMI, smoking, hypertension, and diabetes showed that the hazard ratio (HR) of incidence CKD in women with EEE < 11 compare to those with EEE ≥ 11 years in the subgroup of women aged< 45 years was 2.66(95% CI, 2.2, 3.2), whereas, in the subgroup aged ≥45 years, it was 1.22 (95% CI, 1.04, 1.4). Conclusion This study shows a higher HR of CKD incidence in women with low EEE levels in their later life. Screening of these women for CKD may be recommended. |
topic |
Endogenous estrogen exposure Chronic kidney disease (CKD) Menopause Menarche Estimated glomerular filtration rate (eGFR) |
url |
https://doi.org/10.1186/s12902-021-00817-3 |
work_keys_str_mv |
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