title: Endogenous sex steroid hormones and measures of chronic kidney disease (CKD) in a nationally representative sample of men.
abstract: BACKGROUND
  Sex steroid hormones may play a role in the pathogenesis of chronic kidney disease (CKD).
  
  
  OBJECTIVE
  To determine whether sex steroid hormone concentrations are associated with kidney function or kidney damage in men in the general US population. We hypothesized that lower serum testosterone and E(2) concentrations are associated with CKD. DESIGN PATIENTS AND MEASUREMENTS: Serum sex steroid hormones were measured by electrochemiluminescence immunoassays for 1470 men who attended the morning session of Phase I of the Third National Health and Nutrition Examination Survey (NHANES III). We used two measures of CKD, estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m(2) calculated using serum creatinine or cystatin C levels and the abbreviated Modification of Diet in Renal Disease Study formulae and urinary albumin : creatinine ratio (UACR) >or= 17 mg/g.
  
  
  RESULTS
  Mean free testosterone concentration was higher in men with an eGFR < 60 ml/min/1.73 m(2) than in men with a higher eGFR. In multivariable adjusted models, the odds of an eGFR < 60 ml/min/1.73 m(2) or UACR >/= 17 mg/g did not differ across tertiles of hormones with the exception of free E(2); those in the highest vs. lowest tertile had an elevated odds of decreased eGFR (OR: 3.04, 95% CI (1.22, 7.57); P-trend = 0.02).
  
  
  CONCLUSIONS
  In a nationally representative sample of US adult men, higher free E(2) concentration was significantly associated with an eGFR < 60 ml/min/1.73 m(2) as assessed by serum creatinine or cystatin C even after multivariable adjustment. These findings are in contrast to the hypothesis that oestrogens may protect against CKD, though reverse causation cannot be ruled out. Longitudinal investigation of the role of oestrogens in kidney haemodynamics, function, and pathophysiology is warranted.
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. ssyi@jhsph.edu
authors.forename: Stella
authors.initials: S
authors.lastname: Yi
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Selvin
authors.forename: Sabine
authors.initials: S
authors.lastname: Rohrmann
authors.forename: Shehzad
authors.initials: S
authors.lastname: Basaria
authors.forename: Andy
authors.initials: A
authors.lastname: Menke
authors.forename: Nader
authors.initials: N
authors.lastname: Rifai
authors.forename: Eliseo
authors.initials: E
authors.lastname: Guallar
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Platz
authors.forename: Brad
authors.initials: B
authors.lastname: Astor
mesh_terms: D000328:Adult; D000368:Aged; D003404:Creatinine / Q000652:urine; D003430:Cross-Sectional Studies; D005919:Glomerular Filtration Rate; D012739:Gonadal Steroid Hormones / Q000097:blood*; D006306:Health Surveys; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000175:diagnosis / Q000503:physiopathology*; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D014481:United States
chemical_list: D012739:Gonadal Steroid Hormones; D003404:Creatinine