Donald Fedrigon, Kareem Alazem, S. Sivalingam, M. Monga, Juan Calle
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引用次数: 5
Abstract
Introduction Both elevated testosterone and polycystic ovary syndrome (PCOS) have been speculated as possible risk factors for kidney stone formation; however, the details of this potential relationship with regards to 24-hour urine metabolic panels and stone composition have not previously been characterized. Methods A total of 74 PCOS patients were retrospectively identified and matched with a cohort of female stone formers at a 3 : 1 ratio (by age and BMI). All patients had 24-hour urinary metabolic panels and stone compositions. These groups were compared using Pearson chi-square and Student t-tests. Additionally, the PCOS group was differentiated based on free testosterone using multivariate analysis. Results The case-control cohort showed that PCOS patients had significantly lower sodium excretion (p=0.015) and hypernatriuria rates (28.9% vs 50.9%, p=0.009). The PCOS-testosterone cohort demonstrated that high testosterone patients had significantly higher citrate values (p=0.041) and significantly lower odds of hypocitraturia (36.7% vs 54.2%, OR = 0.2, p=0.042). The high testosterone group also had higher sodium excretion (p=0.058) with significantly higher odds of having hypernatriuria (40.0% vs 13.6%, OR = 13.3, p=0.021). No significant patterns were revealed based on stone composition analysis. Conclusions Compared to healthy stone formers, PCOS patients did not demonstrate significant differences in 24-hour urine and stone composition values. Elevated free testosterone in PCOS patients has a significant association with higher urinary citrate and sodium values: findings that in and of themselves do not confirm the hypothesized increased risk of stone formation. This patient cohort may provide deeper insight into the interplay between androgens and stone formation; however, further study is needed to fully characterize the possible relationship between PCOS and stone formation.
睾丸激素升高和多囊卵巢综合征(PCOS)被推测为肾结石形成的可能危险因素;然而,关于24小时尿液代谢组和结石组成的这种潜在关系的细节以前没有被描述过。方法回顾性分析74例PCOS患者,并将其与女性结石患者按3:1的比例(按年龄和BMI)进行匹配。所有患者均有24小时尿代谢组和结石组成。这些组使用Pearson卡方检验和学生t检验进行比较。此外,采用多变量分析,根据游离睾酮水平对PCOS组进行区分。结果PCOS患者的钠排泄量(p=0.015)和高钠尿率(28.9% vs 50.9%, p=0.009)明显低于PCOS患者。pcos -睾酮队列显示,高睾酮患者的柠檬酸盐值显著升高(p=0.041),低尿率显著降低(36.7% vs 54.2%, OR = 0.2, p=0.042)。高睾酮组的钠排泄量也较高(p=0.058),高钠尿的发生率明显较高(40.0% vs 13.6%, OR = 13.3, p=0.021)。根据岩石成分分析,没有发现明显的图案。结论与健康结石患者相比,PCOS患者24小时尿液和结石组成值无显著差异。PCOS患者游离睾酮水平升高与尿中柠檬酸盐和钠值升高有显著相关性:研究结果本身并不能证实结石形成风险增加的假设。该患者队列可能为雄激素与结石形成之间的相互作用提供更深入的见解;然而,需要进一步的研究来充分表征多囊卵巢综合征和结石形成之间的可能关系。
期刊介绍:
Advances in Urology is a peer-reviewed, open access journal that publishes state-of-the-art reviews and original research papers of wide interest in all fields of urology. The journal strives to provide publication of important manuscripts to the widest possible audience worldwide, without the constraints of expensive, hard-to-access, traditional bound journals. Advances in Urology is designed to improve publication access of both well-established urologic scientists and less well-established writers, by allowing interested scientists worldwide to participate fully.