Sex Hormones and Measures of Kidney Function in the Diabetes Prevention Program Outcomes Study
Abstract Context Despite sex differences in chronic kidney disease (CKD) onset and progression, it is unclear whether endogenous sex hormones are associated with kidney function in persons without CKD. Design and Methods We conducted a secondary analysis of the Diabetes Prevention Program (DPP) and...
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| Veröffentlicht in: | The journal of clinical endocrinology and metabolism 2019-04, Vol.104 (4), p.1171-1180 |
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| container_title | The journal of clinical endocrinology and metabolism |
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| creator | Kim, Catherine Ricardo, Ana C Boyko, Edward J Christophi, Costas A Temprosa, Marinella Watson, Karol E Pi-Sunyer, Xavier Kalyani, Rita R |
| description | Abstract
Context
Despite sex differences in chronic kidney disease (CKD) onset and progression, it is unclear whether endogenous sex hormones are associated with kidney function in persons without CKD.
Design and Methods
We conducted a secondary analysis of the Diabetes Prevention Program (DPP) and its follow-up observational study, the DPP Outcomes Study, over 11 years. Participants included overweight and glucose-intolerant men (n = 889) and pre- and postmenopausal women (n = 1281) not using exogenous sex hormones and whose urine albumin-to-creatinine ratio (ACR) was |
| doi_str_mv | 10.1210/jc.2018-01495 |
| format | Article |
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Context
Despite sex differences in chronic kidney disease (CKD) onset and progression, it is unclear whether endogenous sex hormones are associated with kidney function in persons without CKD.
Design and Methods
We conducted a secondary analysis of the Diabetes Prevention Program (DPP) and its follow-up observational study, the DPP Outcomes Study, over 11 years. Participants included overweight and glucose-intolerant men (n = 889) and pre- and postmenopausal women (n = 1281) not using exogenous sex hormones and whose urine albumin-to-creatinine ratio (ACR) was <30 mg/g and normal estimated glomerular filtration ratio (eGFR) was ≥60 mL/min/1.73 m2 at randomization. We examined the association between sex hormone levels and incidence of low eGFR and/or ACR ≥30 mg/g on at least one measurement.
Results
At randomization, the mean (SD) eGFR was 94 (15) mL/min/1.73 m2; the median ACR (interquartile range) was 4.5 (3.3 to 7.6) mg/g. During follow-up, 187 men (24.6%) and 263 women (24.2%) had incident albuminuria and 136 men (17.9%) and 123 women (11.3%) had incident low eGFR. Among men, higher baseline sex hormone–binding globulin (SHBG) level was associated with reduced low eGFR risk (hazard ratio per SD, 0.80; 95% CI, 0.57 to 0.90) in adjusted analyses. No significant associations were observed among women. There were significant interactions between sex steroid levels and low eGFR by randomization arm.
Conclusion
Sex steroids were not associated with development of low eGFR or albuminuria. Among men, higher SHBG level was associated with reduced risk of low eGFR on at least one measurement.
Sex hormones have been postulated to underlie sex differences in CKD onset and progression. We found SHBG was associated with future reductions in eGFR in men but not in women.</description><identifier>ISSN: 0021-972X</identifier><identifier>EISSN: 1945-7197</identifier><identifier>DOI: 10.1210/jc.2018-01495</identifier><identifier>PMID: 30398516</identifier><language>eng</language><publisher>Washington, DC: Endocrine Society</publisher><subject>Adult ; Albumin ; Albuminuria - blood ; Albuminuria - epidemiology ; Albuminuria - urine ; Body weight ; Chronic kidney failure ; Clinical s ; Creatinine ; Creatinine - urine ; Cross-Sectional Studies ; Development and progression ; Diabetes ; Diabetes mellitus ; Diabetes Mellitus - epidemiology ; Diabetes Mellitus - etiology ; Diabetes Mellitus - prevention & control ; Diabetic Nephropathies - blood ; Diabetic Nephropathies - epidemiology ; Diabetic Nephropathies - etiology ; Disease Progression ; Epidermal growth factor receptors ; Estradiol - blood ; Female ; Follow-Up Studies ; Globulins ; Glomerular Filtration Rate ; Hormones ; Hormones, Sex ; Humans ; Incidence ; Kidney diseases ; Kidney Function Tests ; Male ; Measurement ; Middle Aged ; Overweight ; Overweight - complications ; Post-menopause ; Postmenopausal women ; Prevention programs ; Sex differences ; Sex Factors ; Sex Hormone-Binding Globulin - analysis ; Sex hormones ; Steroid hormones</subject><ispartof>The journal of clinical endocrinology and metabolism, 2019-04, Vol.104 (4), p.1171-1180</ispartof><rights>Copyright © 2019 Endocrine Society 2019</rights><rights>Copyright © Oxford University Press 2015</rights><rights>Copyright © 2019 Endocrine Society.</rights><rights>COPYRIGHT 2019 Oxford University Press</rights><rights>Copyright © 2019 Endocrine Society</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c6025-cdd49069b0925313de90c3a46962ce691a4b456a1a42ce15ce9ad262a1347ca3</citedby><cites>FETCH-LOGICAL-c6025-cdd49069b0925313de90c3a46962ce691a4b456a1a42ce15ce9ad262a1347ca3</cites><orcidid>0000-0001-9237-0532</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/2364254857?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>230,314,780,784,885,21388,21389,27924,27925,33530,33531,33744,33745,43659,43805,64385,64387,64389,72469,73123,73128,73129,73131</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30398516$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kim, Catherine</creatorcontrib><creatorcontrib>Ricardo, Ana C</creatorcontrib><creatorcontrib>Boyko, Edward J</creatorcontrib><creatorcontrib>Christophi, Costas A</creatorcontrib><creatorcontrib>Temprosa, Marinella</creatorcontrib><creatorcontrib>Watson, Karol E</creatorcontrib><creatorcontrib>Pi-Sunyer, Xavier</creatorcontrib><creatorcontrib>Kalyani, Rita R</creatorcontrib><creatorcontrib>Diabetes Prevention Program Research Group</creatorcontrib><creatorcontrib>Diabetes Prevention Program Research Group</creatorcontrib><title>Sex Hormones and Measures of Kidney Function in the Diabetes Prevention Program Outcomes Study</title><title>The journal of clinical endocrinology and metabolism</title><addtitle>J Clin Endocrinol Metab</addtitle><description>Abstract
Context
Despite sex differences in chronic kidney disease (CKD) onset and progression, it is unclear whether endogenous sex hormones are associated with kidney function in persons without CKD.
Design and Methods
We conducted a secondary analysis of the Diabetes Prevention Program (DPP) and its follow-up observational study, the DPP Outcomes Study, over 11 years. Participants included overweight and glucose-intolerant men (n = 889) and pre- and postmenopausal women (n = 1281) not using exogenous sex hormones and whose urine albumin-to-creatinine ratio (ACR) was <30 mg/g and normal estimated glomerular filtration ratio (eGFR) was ≥60 mL/min/1.73 m2 at randomization. We examined the association between sex hormone levels and incidence of low eGFR and/or ACR ≥30 mg/g on at least one measurement.
Results
At randomization, the mean (SD) eGFR was 94 (15) mL/min/1.73 m2; the median ACR (interquartile range) was 4.5 (3.3 to 7.6) mg/g. During follow-up, 187 men (24.6%) and 263 women (24.2%) had incident albuminuria and 136 men (17.9%) and 123 women (11.3%) had incident low eGFR. Among men, higher baseline sex hormone–binding globulin (SHBG) level was associated with reduced low eGFR risk (hazard ratio per SD, 0.80; 95% CI, 0.57 to 0.90) in adjusted analyses. No significant associations were observed among women. There were significant interactions between sex steroid levels and low eGFR by randomization arm.
Conclusion
Sex steroids were not associated with development of low eGFR or albuminuria. Among men, higher SHBG level was associated with reduced risk of low eGFR on at least one measurement.
Sex hormones have been postulated to underlie sex differences in CKD onset and progression. We found SHBG was associated with future reductions in eGFR in men but not in women.</description><subject>Adult</subject><subject>Albumin</subject><subject>Albuminuria - blood</subject><subject>Albuminuria - epidemiology</subject><subject>Albuminuria - urine</subject><subject>Body weight</subject><subject>Chronic kidney failure</subject><subject>Clinical s</subject><subject>Creatinine</subject><subject>Creatinine - urine</subject><subject>Cross-Sectional Studies</subject><subject>Development and progression</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Diabetes Mellitus - epidemiology</subject><subject>Diabetes Mellitus - etiology</subject><subject>Diabetes Mellitus - prevention & control</subject><subject>Diabetic Nephropathies - blood</subject><subject>Diabetic Nephropathies - epidemiology</subject><subject>Diabetic Nephropathies - etiology</subject><subject>Disease Progression</subject><subject>Epidermal growth factor receptors</subject><subject>Estradiol - blood</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Globulins</subject><subject>Glomerular Filtration Rate</subject><subject>Hormones</subject><subject>Hormones, Sex</subject><subject>Humans</subject><subject>Incidence</subject><subject>Kidney diseases</subject><subject>Kidney Function Tests</subject><subject>Male</subject><subject>Measurement</subject><subject>Middle Aged</subject><subject>Overweight</subject><subject>Overweight - complications</subject><subject>Post-menopause</subject><subject>Postmenopausal women</subject><subject>Prevention programs</subject><subject>Sex differences</subject><subject>Sex Factors</subject><subject>Sex Hormone-Binding Globulin - analysis</subject><subject>Sex hormones</subject><subject>Steroid hormones</subject><issn>0021-972X</issn><issn>1945-7197</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kk1v1DAQhiMEokvhyBVF4sIli78TX5CqQimiqJXaAycsrzPZ9ZLEWztp2X_PbHfb0gqwZY3G88xrezxZ9pqSKWWUvF-6KSO0KggVWj7JJlQLWZRUl0-zCSGMFrpk3_eyFyktCTJC8ufZHidcV5KqSfbjHH7lxyF2oYeU277Ov4FNY0QnNPlXX_ewzo_G3g0-9Lnv82EB-UdvZzAgchbhCvqb0FkM82i7_HQcXOgwdj6M9fpl9qyxbYJXO7ufXRx9ujg8Lk5OP385PDgpnCJMFq6uhSZKz4hmklNegyaOW6G0Yg6UplbMhFQWLfpUOtC2ZopZykXpLN_PPmxlV-Osg9rhnaJtzSr6zsa1Cdabh5HeL8w8XBnFNeVSosC7nUAMlyOkwXQ-OWhb20MYk2EUS0awehrRt4_QZRhjj68zjCvBpKhkeU_NbQvG903Ac91G1ByoqlKSaqqQmv6FwllD5x1-SeNx_0FCsU1wMaQUobl7IyVm0w9m6cymH8xNPyD_5s_C3NG3DYAA3QLXoR0gpp_teA3RLMC2w-KxaHErKv6TQ3AIVVYFZmgi0CtwMX5f4zCu_nXt3Qm_AXiK2so</recordid><startdate>201904</startdate><enddate>201904</enddate><creator>Kim, Catherine</creator><creator>Ricardo, Ana C</creator><creator>Boyko, Edward J</creator><creator>Christophi, Costas A</creator><creator>Temprosa, Marinella</creator><creator>Watson, Karol E</creator><creator>Pi-Sunyer, Xavier</creator><creator>Kalyani, Rita R</creator><general>Endocrine Society</general><general>Copyright Oxford University Press</general><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7T5</scope><scope>7TM</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-9237-0532</orcidid></search><sort><creationdate>201904</creationdate><title>Sex Hormones and Measures of Kidney Function in the Diabetes Prevention Program Outcomes Study</title><author>Kim, Catherine ; Ricardo, Ana C ; Boyko, Edward J ; Christophi, Costas A ; Temprosa, Marinella ; Watson, Karol E ; Pi-Sunyer, Xavier ; Kalyani, Rita R</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c6025-cdd49069b0925313de90c3a46962ce691a4b456a1a42ce15ce9ad262a1347ca3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Albumin</topic><topic>Albuminuria - blood</topic><topic>Albuminuria - epidemiology</topic><topic>Albuminuria - urine</topic><topic>Body weight</topic><topic>Chronic kidney failure</topic><topic>Clinical s</topic><topic>Creatinine</topic><topic>Creatinine - urine</topic><topic>Cross-Sectional Studies</topic><topic>Development and progression</topic><topic>Diabetes</topic><topic>Diabetes mellitus</topic><topic>Diabetes Mellitus - epidemiology</topic><topic>Diabetes Mellitus - etiology</topic><topic>Diabetes Mellitus - prevention & control</topic><topic>Diabetic Nephropathies - blood</topic><topic>Diabetic Nephropathies - epidemiology</topic><topic>Diabetic Nephropathies - etiology</topic><topic>Disease Progression</topic><topic>Epidermal growth factor receptors</topic><topic>Estradiol - blood</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Globulins</topic><topic>Glomerular Filtration Rate</topic><topic>Hormones</topic><topic>Hormones, Sex</topic><topic>Humans</topic><topic>Incidence</topic><topic>Kidney diseases</topic><topic>Kidney Function Tests</topic><topic>Male</topic><topic>Measurement</topic><topic>Middle Aged</topic><topic>Overweight</topic><topic>Overweight - complications</topic><topic>Post-menopause</topic><topic>Postmenopausal women</topic><topic>Prevention programs</topic><topic>Sex differences</topic><topic>Sex Factors</topic><topic>Sex Hormone-Binding Globulin - analysis</topic><topic>Sex hormones</topic><topic>Steroid hormones</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kim, Catherine</creatorcontrib><creatorcontrib>Ricardo, Ana C</creatorcontrib><creatorcontrib>Boyko, Edward J</creatorcontrib><creatorcontrib>Christophi, Costas A</creatorcontrib><creatorcontrib>Temprosa, Marinella</creatorcontrib><creatorcontrib>Watson, Karol E</creatorcontrib><creatorcontrib>Pi-Sunyer, Xavier</creatorcontrib><creatorcontrib>Kalyani, Rita R</creatorcontrib><creatorcontrib>Diabetes Prevention Program Research Group</creatorcontrib><creatorcontrib>Diabetes Prevention Program Research Group</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Immunology Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The journal of clinical endocrinology and metabolism</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kim, Catherine</au><au>Ricardo, Ana C</au><au>Boyko, Edward J</au><au>Christophi, Costas A</au><au>Temprosa, Marinella</au><au>Watson, Karol E</au><au>Pi-Sunyer, Xavier</au><au>Kalyani, Rita R</au><aucorp>Diabetes Prevention Program Research Group</aucorp><aucorp>Diabetes Prevention Program Research Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Sex Hormones and Measures of Kidney Function in the Diabetes Prevention Program Outcomes Study</atitle><jtitle>The journal of clinical endocrinology and metabolism</jtitle><addtitle>J Clin Endocrinol Metab</addtitle><date>2019-04</date><risdate>2019</risdate><volume>104</volume><issue>4</issue><spage>1171</spage><epage>1180</epage><pages>1171-1180</pages><issn>0021-972X</issn><eissn>1945-7197</eissn><abstract>Abstract
Context
Despite sex differences in chronic kidney disease (CKD) onset and progression, it is unclear whether endogenous sex hormones are associated with kidney function in persons without CKD.
Design and Methods
We conducted a secondary analysis of the Diabetes Prevention Program (DPP) and its follow-up observational study, the DPP Outcomes Study, over 11 years. Participants included overweight and glucose-intolerant men (n = 889) and pre- and postmenopausal women (n = 1281) not using exogenous sex hormones and whose urine albumin-to-creatinine ratio (ACR) was <30 mg/g and normal estimated glomerular filtration ratio (eGFR) was ≥60 mL/min/1.73 m2 at randomization. We examined the association between sex hormone levels and incidence of low eGFR and/or ACR ≥30 mg/g on at least one measurement.
Results
At randomization, the mean (SD) eGFR was 94 (15) mL/min/1.73 m2; the median ACR (interquartile range) was 4.5 (3.3 to 7.6) mg/g. During follow-up, 187 men (24.6%) and 263 women (24.2%) had incident albuminuria and 136 men (17.9%) and 123 women (11.3%) had incident low eGFR. Among men, higher baseline sex hormone–binding globulin (SHBG) level was associated with reduced low eGFR risk (hazard ratio per SD, 0.80; 95% CI, 0.57 to 0.90) in adjusted analyses. No significant associations were observed among women. There were significant interactions between sex steroid levels and low eGFR by randomization arm.
Conclusion
Sex steroids were not associated with development of low eGFR or albuminuria. Among men, higher SHBG level was associated with reduced risk of low eGFR on at least one measurement.
Sex hormones have been postulated to underlie sex differences in CKD onset and progression. We found SHBG was associated with future reductions in eGFR in men but not in women.</abstract><cop>Washington, DC</cop><pub>Endocrine Society</pub><pmid>30398516</pmid><doi>10.1210/jc.2018-01495</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0001-9237-0532</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Albumin Albuminuria - blood Albuminuria - epidemiology Albuminuria - urine Body weight Chronic kidney failure Clinical s Creatinine Creatinine - urine Cross-Sectional Studies Development and progression Diabetes Diabetes mellitus Diabetes Mellitus - epidemiology Diabetes Mellitus - etiology Diabetes Mellitus - prevention & control Diabetic Nephropathies - blood Diabetic Nephropathies - epidemiology Diabetic Nephropathies - etiology Disease Progression Epidermal growth factor receptors Estradiol - blood Female Follow-Up Studies Globulins Glomerular Filtration Rate Hormones Hormones, Sex Humans Incidence Kidney diseases Kidney Function Tests Male Measurement Middle Aged Overweight Overweight - complications Post-menopause Postmenopausal women Prevention programs Sex differences Sex Factors Sex Hormone-Binding Globulin - analysis Sex hormones Steroid hormones |
| title | Sex Hormones and Measures of Kidney Function in the Diabetes Prevention Program Outcomes Study |
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