Chávez Valencia Venice, Mejía Rodríguez Oliva, Viveros Sandoval Martha Eva, Abraham Bermúdez Juan, Gutiérrez Castellanos Sergio, Orizaga de la Cruz Citlalli, Roa Córdova Martha Alicia
Hospital General Regional N.(o) 1 IMSS, Morelia, Michoacán, México; Facultad de Ciencias Médicas y Biológicas, Universidad Michoacana de San Nicolás de Hidalgo, Morelia, Michoacán, México.
Centro de Investigación Biomédica de Michoacán, IMSS, Michoacán, México.
Nefrologia (Engl Ed). 2018 Jan-Feb;38(1):57-63. doi: 10.1016/j.nefro.2017.07.001. Epub 2017 Oct 26.
Low levels of thyroid hormones, total triiodothyronine (T3) and free triiodothyronine (FT3) in haemodialysis patients is a marker of malnutrition and inflammation and are predictors of mortality. The aim of this study was to determine the prevalence of malnutrition-inflammation complex syndrome in haemodialysis and its relationship with the thyroid hormones thyrotropin, T3, FT3 and free thyroxine (FT4), as well as to evaluate the prevalence of low FT3 syndrome and its correlation with nutritional and inflammatory markers.
Cross-sectional, analytical and comparative study that enrolled 128 haemodialysis patients: 50.8% females; mean age 45.05±17.01 years; mean time on haemodialysis 45.4±38.8 months; 29.7% diabetics; 79.7% with hypertension. Serum thyroid hormones thyrotropin, T3, FT3 and FT4 concentrations were measured and Malnutritition-Inflammation Score (MIS) was applie to diagnostic.
Mean thyroid hormone values were: thyroid hormones thyrotropin 2.48±1.8 mIU/ml (range: 0.015-9.5), T3 1.18±0.39 ng/ml (range 0.67-2.64), FT3 5.21±0.96pmol/l (range: 3.47-9.75); FT4 1.35±0.4 ng/ml (range: 0.52-2.57). Malnutrition-inflammation complex syndrome prevalence was 53.9%; 11.7% presented low FT3 levels. Serum T3 and FT3 concentrations inversely correlated with Malnutritition-Inflammation Score (MIS), while FT4 correlated positively with Malnutrition-Inflammation Score. In the linear regression analysis, low FT3 was associated with IL-6 (β= 0.265, p=.031), C-reactive protein (CRP) (β= -0.313, p=.018) and albumin (β= 0.276, p=.002).
Low T3 and FT3 levels are correlated with malnutrition and inflammation parameters. Malnutrition-inflammation complex syndrome can affect serum concentrations of thyroid hormones.
血液透析患者甲状腺激素、总三碘甲状腺原氨酸（T3）和游离三碘甲状腺原氨酸（FT3）水平较低是营养不良和炎症的标志物，也是死亡率的预测指标。本研究的目的是确定血液透析中营养不良-炎症复合综合征的患病率及其与甲状腺激素促甲状腺激素、T3、FT3和游离甲状腺素（FT4）的关系，以及评估低FT3综合征的患病率及其与营养和炎症标志物的相关性。
一项横断面、分析性和对比性研究，纳入了128例血液透析患者：女性占50.8%；平均年龄45.05±17.01岁；平均血液透析时间45.4±38.8个月；糖尿病患者占29.7%；高血压患者占79.7%。测量血清甲状腺激素促甲状腺激素、T3、FT3和FT4浓度，并应用营养不良-炎症评分（MIS）进行诊断。
甲状腺激素平均水平为：促甲状腺激素2.48±1.8 mIU/ml（范围：0.015 - 9.5），T3 1.18±0.39 ng/ml（范围0.67 - 2.64），FT3 5.21±0.96pmol/l（范围：3.47 - 9.75）；FT4 1.35±0.4 ng/ml（范围：0.52 - 2.57）。营养不良-炎症复合综合征患病率为53.9%；11.7%的患者FT3水平较低。血清T3和FT3浓度与营养不良-炎症评分（MIS）呈负相关，而FT4与营养不良-炎症评分呈正相关。在线性回归分析中，低FT3与白细胞介素-6（β = 0.265，p = 0.031）、C反应蛋白（CRP）（β = -0.313，p = 0.018）和白蛋白（β = 0.276，p = 0.002）相关。
低T3和FT3水平与营养不良和炎症参数相关。营养不良-炎症复合综合征可影响甲状腺激素的血清浓度。
