Clinical and biochemical implications of low thyroid hormone levels (total and free forms) in euthyroid patients with chronic kidney disease
| Autor: | Abdul Rashid Qureshi, Peter Stenvinkel, Jonas Axelsson, Peter Bárány, Olof Heimbürger, Juan Jesus Carrero, M. R. Witt, Mohamed E. Suliman, Mahmut Ilker Yilmaz, Bengt Lindholm, S. Rehnmark, Anders Alvestrand |
|---|---|
| Rok vydání: | 2007 |
| Předmět: |
medicine.medical_specialty
education.field_of_study Triiodothyronine biology business.industry Thyroid C-reactive protein Population Poison control medicine.disease medicine.anatomical_structure Endocrinology Internal medicine Internal Medicine biology.protein Medicine Euthyroid business education Kidney disease Hormone |
| Zdroj: | Journal of Internal Medicine. 262:690-701 |
| ISSN: | 0954-6820 |
| DOI: | 10.1111/j.1365-2796.2007.01865.x |
| Popis: | Carrero JJ, Qureshi AR, Axelsson J, Yilmaz MI, Rehnmark S, Witt MR, Barany P, Heimburger O, Suliman ME, Alvestrand A, Lindholm B, Stenvinkel P (Karolinska Institutet, Stockholm; and Karo Bio AB, Novum, Huddinge; Sweden). Clinical and biochemical implications of low thyroid hormone levels (total and free forms) in euthyroid patients with chronic kidney disease. J Intern Med 2007; 262: 690–701. Objectives. In this study, we explore the associations of decreased thyroid hormone levels with inflammation, wasting and survival in biochemically euthyroid patients with end-stage renal disease (ESRD). Design. After exclusion of 23 patients with thyroid-stimulating hormone (TSH) values outside the normal range (0.1–4.5 mIU L−1), 187 clinically and biochemically euthyroid incident ESRD stage 5 patients starting dialysis were followed for a median of 20 (range 1–60) months. Measurements of total and free forms of thyroid hormones, s-albumin, hs-CRP, interleukin (IL)-6, vascular adhesion molecule (VCAM)-1 and insulin-like growth factor 1 (IGF-1) were performed at baseline. Results. In this population, 17 out of 210 patients (8%) were defined as subclinically hypothyroid. Multivariate analysis, according to receiver operating characteristic (ROC) curves, showed that mortality was best predicted by total triiodothyronine (T3). When using the cut-off levels derived from ROC, low T3 levels were associated with increased inflammation (higher hs-CRP, IL-6 and VCAM-1) and lower concentration of both s-albumin and IGF-1. Finally, low T3 but not low free triiodothyronine was associated with worse all-cause (Likelihood ratio = 45.4; P |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text