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

Abstract

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.

The magnesium depletion score is associated with increased likelihood of kidney stone disease among female adults

“…Huang et al raised that serum TST may be a protective factor in men over 40 years too [42]. However, recent researches have suggested that female patients with PCOS are two to three times more likely to develop kidney stones [20] and that low serum magnesium status in these patients may be associated with higher testosterone levels [47]. It appears that these results are inconsistent with ours, but it is worth note that patients with PCOS, which is characterized by chronic low-level in ammation [48], are prone to suffer from kidney stone formation resulting from immune dysregulation.…”

“…Through different mechanisms, a low magnesium state leads to poor urinary magnesium excretion and leads to urinary calcium oxalate supersaturation with an increased likelihood of formation of insoluble complexes [19]. It has recently been reported in the literature that women with polycystic ovary syndrome (PCOS), particularly those who present with irregular menstruation and polycystic ovary morphology (PCOM) on ultrasound, have a higher likelihood of developing kidney stones [20].…”

Association between Polycystic Ovarian Syndrome, Impaired Kidney Function and Hyperuricaemia: A Systematic Review and Meta-analysis

“…[ 26 ] These conditions have the potential to cause alterations in kidney function, characterised by the presence of protein in the urine and changes in some kidney function parameters. [ 27 ] The changes in serum creatinine, eGFR and/or blood urea nitrogen from peripheral blood can be used to depict the reduction of kidney function. [ 28 ]…”