Sex Steroid Hormone Levels May Not Explain Gender Differences in Development of Nephrolithiasis

Knoedler, John J.; Krambeck, Amy E.; Astorne, Walter; Bergstralh, Erik J.; Lieske, John C.

doi:10.1089/end.2015.0255

Cited by 6 publications

(4 citation statements)

References 19 publications

(29 reference statements)

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“…The same result was also observed in our cohort study. However, the exact pathophysiology of gender difference in urolithiasis remains uncertain [ 19 ]. Some studies stressed on the protective effect of estrogen, while others concluded testosterone as a risk factor.…”

Section: Discussionmentioning

confidence: 99%

Study on the prevalence and incidence of urolithiasis in Korea over the last 10 years: An analysis of National Health Insurance Data

2018

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PurposeWe aimed to analyze the incidence and prevalence of urolithiasis in Korea over the last decade using the National Health Insurance (NHI) sample cohort data.Materials and MethodsFrom January 2002 to December 2013, we enrolled sample cohort data from the NHI. Patients diagnosed with international classification of diseases code N20 or N13.2 were included. The incidence and prevalence rate was counted from the same period and patients previously diagnosed with urolithiasis were excluded. We compared the incidence and prevalence of urolithiasis by region, age, and sex, and identified the changes.ResultsTotal 1,111,828 subjects were included. Of these subjects, 36,857 had urolithiasis. The male-to-female ratio was 1.57:1, and total incidence rate was 3.27 per 1,000 person-years (1,000p-yrs). The annual incidence was lowest in 2013 (3,138 patients) and highest in 2005 (3,751 patients). Incidence rate by diagnostic code was highest in ureter stone only (2.49 per 1,000p-yrs) and was lowest in kidney and ureter stone both (0.17 per 1,000p-yrs). Prevalence gradually increased from 3,172 in 2002 and 5,758 in 2013. Jeollanam-do had the highest incidence rate of 3.70 persons per 1,000p-yrs, and Jeju had the lowest rate of 2.84 persons per 1,000p-yrs. In gender analysis, Daegu had the highest incidence (4.56) in males, Jeollanam-do had the highest incidence (3.20) in females.ConclusionsAnnual incidence remained stable, whereas prevalence gradually increased. The incidence in male was 1.57 times higher than female, and the peak incidence age was 45–49 years, with the highest incidence occurring in Jeollanam-do and the lowest in Jeju.

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Section: Discussionmentioning

confidence: 99%

Study on the prevalence and incidence of urolithiasis in Korea over the last 10 years: An analysis of National Health Insurance Data

2018

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“…Despite all this evidence, the relationship between testosterone levels and nephrolithiasis is still in the aura of uncertainty and is a subject of ongoing research. While some studies have reported an association between elevated testosterone levels and an increased risk of kidney stones, other studies have not found any correlation [11,12,24,[31][32][33][34].…”

Section: Discussionmentioning

confidence: 93%

The Hidden Link between Polycystic Ovary Syndrome and Kidney Stones: Finding from the Tehran Lipid and Glucose Study (TLGS)

Rostami Dovom,

Rahmati,

Amanollahi Soudmand

et al. 2023

Diagnostics

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Background: We aimed to investigate the association between kidney stones and polycystic ovarian syndrome (PCOS). Materials and methods: In a cross-sectional study, data from the Tehran Lipid and Glucose Study (TLGS) were used to investigate the risk of kidney stones in women with Polycystic Ovary Syndrome (PCOS). Four distinct phenotypes of PCOS, as defined by the Rotterdam criteria, were examined in a sample of 520 women and compared to a control group of 1638 eumenorrheic non-hirsute healthy women. Univariate and multivariable logistic regression models were employed for analysis. The four PCOS phenotypes were classified as follows: Phenotype A, characterized by the presence of all three PCOS features (anovulation (OA), hyperandrogenism (HA), and polycystic ovarian morphology on ultrasound (PCOM)); Phenotype B, characterized by the presence of anovulation and hyperandrogenism; Phenotype C, characterized by the presence of hyperandrogenism and polycystic ovarian morphology on ultrasound; and Phenotype D, characterized by the presence of anovulation and polycystic ovarian morphology on ultrasound. Results: The prevalence of a history of kidney stones was found to be significantly higher in women with Polycystic Ovary Syndrome (PCOS) compared to healthy controls (12.5% vs. 7.7%, p = 0.001). This increased prevalence was observed across all PCOS phenotypes (p < 0.001). After adjusting for potential risk factors, including age, family history of kidney stones, waist-to-height ratio, total cholesterol, and low-density lipoprotein, the odds ratio for kidney stones in women with PCOS was found to be 1.59 [95% CI: 1.12–2.25, p = 0.01], indicating a 59% increase in risk compared to healthy women. Women with PCOS Phenotype A [OR: 1.97, 95% CI: 1.09–3.55, p = 0.02] and Phenotype D [OR: 3.03, 95% CI: 1.24–7.41, p = 0.01] were found to be at a higher risk for kidney stones. Conclusion: Women with Polycystic Ovary Syndrome (PCOS), particularly those exhibiting menstrual irregularities and polycystic ovarian morphology on ultrasound (PCOM), have been found to be two to three times more likely to develop kidney stones. This increased prevalence should be taken into consideration when providing preventive care and counseling to these individuals.

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“…Clouding the discussion further, one study reported an increased risk of stones with lower testosterone levels [20]. A single study found no association with testosterone [21]. Our endocrinologists only evaluate free testosterone due to previous evidence that it is more sensitive than total testosterone for the diagnosis of hyperandrogenic disorders such as PCOS [22].…”

Section: Discussionmentioning

confidence: 99%

Nephrolithiasis and Polycystic Ovary Syndrome: A Case-Control Study Evaluating Testosterone and Urinary Stone Metabolic Panels

Fedrigon

Alazem

Sivalingam

et al. 2019

Advances in Urology

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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.

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Sex Steroid Hormone Levels May Not Explain Gender Differences in Development of Nephrolithiasis

Abstract: We found no significant association of sex steroid hormone levels with the risk of nephrolithiasis formation in men, although a weak trend toward an increased risk with elevated testosterone was seen.

Cited by 6 publications

References 19 publications

Study on the prevalence and incidence of urolithiasis in Korea over the last 10 years: An analysis of National Health Insurance Data

Study on the prevalence and incidence of urolithiasis in Korea over the last 10 years: An analysis of National Health Insurance Data

The Hidden Link between Polycystic Ovary Syndrome and Kidney Stones: Finding from the Tehran Lipid and Glucose Study (TLGS)

Nephrolithiasis and Polycystic Ovary Syndrome: A Case-Control Study Evaluating Testosterone and Urinary Stone Metabolic Panels

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