Department of General Internal Medicine, Kyushu University Hospital.
Department of Environmental Medicine and Infectious Disease, Graduate School of Medical Sciences, Kyushu University.
J Atheroscler Thromb. 2018 Apr 1;25(4):335-343. doi: 10.5551/jat.41251. Epub 2017 Oct 18.
The present large-scale Japanese population study was performed to evaluate the relation between the serum thyroid stimulating hormone (TSH) level and renal function.
Out of 1,374 residents who participated in a free public physical examination between 2010 and 2011, we evaluated the data of 888 participants for whom the serum TSH level and estimated glomerular filtration rate (eGFR) were successfully measured. The participants were categorized into three groups based on TSH levels (normal TSH, ≤2.4; high-normal TSH, 2.5-4.4; and subclinical hypothyroid, ≥4.5 μIU/mL). Multiple linear regression analysis adjusted for cardiovascular risk factors was performed to determine the relationship between serum TSH level and renal function.
The mean±SD TSH level was 2.0±1.4 μIU/mL, and 75.9% (n=674) of the participants had normal, 17.9% (n=159) had high-normal, and 6.2% (n=55) had subclinical hypothyroid TSH levels. The mean eGFR significantly decreased with increased TSH levels (normal TSH, 79.3±14.1; high-normal TSH, 77.4±13.0; and subclinical hypothyroid, 72.3±12.2 mL/min/1.73 m: P for trend <0.01). Multiple linear regression analysis extracted log-transformed TSH level as an independent factor correlated with eGFR in the high-normal TSH group (beta=-0.18, P=0.02).
Our findings demonstrated a significant correlation between serum TSH levels and eGFR in high-normal TSH participants. In healthy individuals, high-normal TSH levels indicate increased the risk of chronic kidney disease.
本项大规模日本人群研究旨在评估血清促甲状腺激素(TSH)水平与肾功能之间的关系。
在 2010 年至 2011 年期间参加免费公共体检的 1374 名居民中,我们评估了 888 名成功测量血清 TSH 水平和估算肾小球滤过率(eGFR)的参与者的数据。根据 TSH 水平(正常 TSH,≤2.4;高正常 TSH,2.5-4.4;亚临床甲状腺功能减退,≥4.5μIU/mL)将参与者分为三组。进行多变量线性回归分析以确定血清 TSH 水平与肾功能之间的关系,分析调整了心血管危险因素。
平均 TSH 水平±SD 为 2.0±1.4μIU/mL,75.9%(n=674)的参与者 TSH 水平正常,17.9%(n=159)的参与者 TSH 水平高正常,6.2%(n=55)的参与者 TSH 水平亚临床甲状腺功能减退。随着 TSH 水平的升高,eGFR 显著降低(正常 TSH,79.3±14.1;高正常 TSH,77.4±13.0;亚临床甲状腺功能减退,72.3±12.2 mL/min/1.73 m:P 趋势<0.01)。多变量线性回归分析提取出 TSH 水平的对数值作为与高正常 TSH 组 eGFR 相关的独立因素(β=-0.18,P=0.02)。
我们的研究结果表明,在高正常 TSH 组参与者中,血清 TSH 水平与 eGFR 之间存在显著相关性。在健康个体中,高正常 TSH 水平表明慢性肾脏病的风险增加。