TY - JOUR
T1 - Sex hormones and measures of kidney function in the diabetes prevention program outcomes study
AU - Kim, Catherine
AU - Ricardo, Ana C.
AU - Boyko, Edward J.
AU - Christophi, Costas A.
AU - Temprosa, Marinella
AU - Watson, Karol E.
AU - Pi-Sunyer, Xavier
AU - Kalyani, Rita R.
N1 - Funding Information:
Financial Support: This study was supported by Grants DK072041, DK048489, and DK53061 (to C.K.) from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), which provided funding to the clinical centers and the coordinating center for the design and conduct of the study, and collection, management, analysis, and interpretation of the data. The Southwestern American Indian Centers were supported directly by NIDDK, including its Intramural Research Program, and the Indian Health Service. The General Clinical Research Center Program, National Center for Research Resources, and the Department of Veterans Affairs supported data collection at many of the clinical centers. Funding was also provided by the National Institute of Child Health and Human Development, National Institute on Aging, National Eye Institute, National Heart Lung and Blood Institute, Office of Research on Women’s Health, National Institute on Minority Health and Health Disparities, Centers for Disease Control and Prevention, and American Diabetes Association. Bristol-Myers Squibb and Parke-Davis provided additional funding and material support during DPP, Lipha (Merck-Sante) provided medication, and LifeScan donated materials during DPP and DPPOS. The opinions expressed herein are those of the investigators and do not necessarily reflect the views of the funding agencies.
Publisher Copyright:
© 2019 Endocrine Society.
PY - 2019/4/1
Y1 - 2019/4/1
N2 - 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- A nd postmenopausal women (n = 1281) not using exogenous sex hormones andwhose 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.
AB - 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- A nd postmenopausal women (n = 1281) not using exogenous sex hormones andwhose 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.
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U2 - 10.1210/jc.2018-01495
DO - 10.1210/jc.2018-01495
M3 - Article
C2 - 30398516
AN - SCOPUS:85064223502
SN - 0021-972X
VL - 104
SP - 1171
EP - 1180
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
IS - 4
ER -