Wang Kunlin, Xie Kaipeng, Gu Liubao, Xu Bo, Chen Jihai, Lou Qinglin, Yu Yun, Shan Shan, Wu Dan, Dai Linli, Hu Cuining, Shen Zhixiang, Tang Wei
Department of Endocrinology, Islet Cell Senescence and Function Research Laboratory, Jiangsu Province Geriatric Institute, Nanjing, China.
Department of Women Health Care, The Affiliated Obstetrics and Gynecology Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China.
Kidney Blood Press Res. 2018;43(4):1075-1083. doi: 10.1159/000491069. Epub 2018 Jul 5.
BACKGROUND/AIMS: We aimed to explore whether thyroid function within a normal range is associated with the estimated glomerular filtration rate (eGFR) and the incidence of chronic kidney disease (CKD) in a large Chinese population.
We conducted a cross-sectional study that included 10,859 euthyroid individuals who underwent an annual regular health checkup in Jiangsu Province Official Hospital between August 2012 and August 2013. We measured the thyroid-stimulating hormone (TSH), free triiodothyronine (FT3) and free thyroxine (FT4) levels using a Roche modular analytics E170 and then calculated the eGFR using the Chinese modified Modification of Diet in Renal Disease (CMDRD) equation.
In multiple linear regression models, TSH was negatively associated with eGFR after adjusting for confounding factors (β = -0.072, P = 1.994×10-22). The significance remained in both males and females. No significant association was observed between FT4 and eGFR. In the logistic regression model, we did not observe significant associations of TSH or FT3 with CKD. Participants in the highest quartile of FT4 versus the lowest quartile (reference) had an increased risk of CKD (OR = 1.763, P = 0.012). The risk of CKD was more pronounced in females with the highest quartile of FT4 (OR = 2.424, P = 0.029).
Our findings suggest that TSH is associated with eGFR in euthyroid individuals and that higher FT4 is associated with an increased risk of CKD. More cohort studies are warranted to confirm whether the association is causal.
背景/目的:我们旨在探讨在中国的一大群人中,正常范围内的甲状腺功能是否与估计肾小球滤过率(eGFR)及慢性肾脏病(CKD)的发病率相关。
我们进行了一项横断面研究,纳入了2012年8月至2013年8月期间在江苏省立医院进行年度定期健康检查的10859名甲状腺功能正常的个体。我们使用罗氏模块化分析E170测定促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)和游离甲状腺素(FT4)水平,然后使用中国改良的肾脏病饮食改良(CMDRD)方程计算eGFR。
在多元线性回归模型中,校正混杂因素后,TSH与eGFR呈负相关(β = -0.072,P = 1.994×10-22)。在男性和女性中均保持显著意义。未观察到FT4与eGFR之间存在显著关联。在逻辑回归模型中,我们未观察到TSH或FT3与CKD之间存在显著关联。FT4最高四分位数组的参与者与最低四分位数组(参照)相比,患CKD的风险增加(OR = 1.763,P = 0.012)。FT4最高四分位数组的女性患CKD的风险更为明显(OR = 2.424,P = 0.029)。
我们的研究结果表明,甲状腺功能正常的个体中TSH与eGFR相关,且较高的FT4与CKD风险增加相关。需要更多的队列研究来证实这种关联是否为因果关系。