Endocrine Abstracts

Objective: Kidney function is known to be interrelated with the aging process. On the other hand, a number of studies support a link between the menopausal transition and kidney function, either directly or indirectly, secondary to the effect of the alternating hormone environment or the effect of the accumulated cardiovascular risk factors, respectively. We aimed to evaluate the cross-sectional association between kidney function and sex hormones at the time of the menopausal transition and beyond, in a sample of peri- and postmenopausal women.

Methods: We evaluated retrospectively the data of 217 women, recruited from the 2nd Department of Obstetrics and Gynaecology, Menopause Clinic, Athens, Greece. For the purpose of this study we reviewed electronic patient files, with normal to moderate kidney function (eGFR > 60 mL/min/1.72m²) corresponding to consultations in the clinic. Women were stratified according to their reproductive status as perimenopausal, so 12 months prior up to 12 months after the final menstrual period (FMP), early postmenopausal (1-5 years after the FMP) and late postmenopausal (>5 years after the FMP). Biochemical data were recorded including sex hormone levels. Kidney function was evaluated using the equation for CKD-EPI 2021.

Results: Women of this sample were aged 53.29±7.6 years, and were slightly overweight with a body mass index (BMI) of 26.36±4.12 kg/m². The baseline eGFR-EPI value was 94.2±7.67. Correlation analysis showed that eGFR-EPI values are related to stimulated hormone (FSH, r=-0.198, P=0.005) but not with total or free circulating estrogen, testosterone levels, or sex hormone binding globulin (SHBG). The eGFR-EPI values also correlated with menopausal age (r=-0.177, P=0.003). We evaluated eGFR-EPI values per reproductive status, kidney function decreased linearly with advancing reproductive status, estimated as values of eGFR-EPI (mL/min/1.73m²): perimenopausal women (n=81), 97.8±13.5 vs early postmenopausal women (n=74), 92.1±15.7 vs late postmenopausal women (n=100), 91.7±12.9 (p for linear trend 0.005). Linear regression analysis showed that values of eGFR were associated with FSH (b-coefficient = -0.150, P=0.010) and age (b-coefficient = -0.270, P<0.001) with R2 of 9.5%. The model was adjusted for current smoking, homeostasis model assessment of insulin resistance, mean arterial pressure, waist to hip ratio, triglycerides, free estrogen index.

Conclusion: The results of this study highlight an association between the peri- and postmenopausal fluctuation of FSH and the kidney function in women. Further longitudinal studies are required to confirm our findings.