Thyroid function and cardiovascular events in chronic kidney disease patients

Autor: Hilmi Umut Unal, Tayfun Eyileten, Baris Afsar, Mustafa Gezer, Mutlu Saglam, Mahmut Ilker Yilmaz, Alper Sonmez, Yusuf Oguz, Adrian Covic, Mehmet Kanbay, Dimitrie Siriopol, Murat Karaman, Ibrahim Aydin, Salih Hamcan
Rok vydání: 2016
Předmět:
Male
Turkey
endocrine system diseases
Thyroid Gland
030232 urology & nephrology
Kaplan-Meier Estimate
Thyroid Function Tests
030204 cardiovascular system & hematology
Kidney
Carotid Intima-Media Thickness
0302 clinical medicine
Risk Factors
Prevalence
Medicine
Euthyroid
Subclinical infection
medicine.diagnostic_test
Thyroid
Middle Aged
Prognosis
Vasodilation
medicine.anatomical_structure
Cardiovascular Diseases
Nephrology
cardiovascular system
Cardiology
Female
Inflammation Mediators
Thyroid function
hormones
hormone substitutes
and hormone antagonists
Adult
Thyroid Hormones
endocrine system
medicine.medical_specialty
Hyperemia
Thyroid function tests
03 medical and health sciences
Hypothyroidism
Internal medicine
Diabetes mellitus
Humans
cardiovascular diseases
Renal Insufficiency
Chronic
Aged
business.industry
medicine.disease
Euthyroid Sick Syndromes
Fibroblast Growth Factors
Fibroblast Growth Factor-23
Asymptomatic Diseases
Endothelium
Vascular
business
Biomarkers
Kidney disease
Euthyroid sick syndrome
Zdroj: Journal of Nephrology. 30:235-242
ISSN: 1724-6059
1121-8428
Popis: Abnormalities of thyroid function are commonly seen in chronic kidney disease (CKD) patients. They are associated with adverse clinical conditions such as atherosclerosis, endothelial dysfunction, inflammation and abnormal blood pressure variability. We investigated the association between thyroid disorders and endothelial function, assessed by flow-mediated dilatation (FMD) and carotid intima-media thickness (CIMT), and cardiovascular events (CVE) in CKD patients. This observational cohort study included 305 CKD (stages 1–5) patients. Routine biochemistry, including free T3, free T4 and thyroid stimulating hormone, fibroblast growth factor-23 (FGF-23) and FMD, CIMT were measured. We divided patients into four groups according to thyroid hormone status: euthyroidism, subclinical hyperthyroidism, subclinical hypothyroidism, and euthyroid sick syndrome. Fatal and composite CVE were recorded for a median 29 months. Patients with subclinical hypothyroidism had a higher prevalence of hypertension and diabetes and also were more likely to have higher values of systolic CIMT, phosphorus, intact parathormone (iPTH), FGF-23, homeostasis model assessment-insulin resistance and lower levels of FMD than euthyroid patients. In the unadjusted survival analysis, subclinical hypothyroidism and euthyroid sick syndrome were associated with an increased risk for the outcome as compared with euthyroidism [hazard ratio 30.63 (95 % confidence interval 12.27–76.48) and 12.17 (3.70–39.98), respectively]. The effects of subclinical hypothyroidism and euthyroid sick syndrome were maintained even in fully adjusted models. We demonstrated that subclinical hypothyroidism and euthyroid sick syndrome are associated with increased CVE in CKD patients. Further studies are needed to explore these issues.
Databáze: OpenAIRE
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