Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama, 700-8558, Japan.
Department of Chronic Kidney Disease and Cardiovascular Disease, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Sci Rep. 2022 Sep 2;12(1):14999. doi: 10.1038/s41598-022-19226-0.
Hypothyroidism is known to be correlated with kidney function and nephrotic range proteinuria. However, it is uncertain whether non-nephrotic proteinuria is associated with hypothyroidism. This study aimed to evaluate the association of proteinuria and hypothyroidism in chronic kidney disease (CKD) patients. We conducted a cross-sectional study composed of 421 CKD patients in a single hospital with measurements of 24-h urine protein excretion (UP) and thyroid function tests. Spearman correlation analysis revealed that 24-h Cr clearance (24hrCcr) was positively (r = 0.273, p < 0.001) and UP was negatively (r = - 0.207, p < 0.001) correlated with free triiodothyronine. Frequency distribution analysis stratified by CKD stage and UP for hypothyroidism revealed that the prevalence of hypothyroidism was higher among participants with higher CKD stage and nephrotic range proteinuria. Multivariate logistic regression analysis revealed that 24hrCcr and UP were significantly correlated with hypothyroidism (24hrCcr/10 mL/min decrease: odds ratio [OR], 1.29; 95% confidence interval [CI], 1.18-1.41; UP/1 g increase: OR, 1.10; 95% CI, 1.03-1.17). In addition, nephrotic range proteinuria, but not moderate UP (UP: 1.5-3.49 g/day), was significantly correlated with hypothyroidism compared to UP < 0.5 g/day. In summary, decreased kidney function and nephrotic range proteinuria, not non-nephrotic proteinuria, are independently associated with the hypothyroidism.
甲状腺功能减退症与肾功能和肾病范围蛋白尿相关。然而，非肾病范围蛋白尿是否与甲状腺功能减退症相关仍不确定。本研究旨在评估慢性肾脏病（CKD）患者蛋白尿与甲状腺功能减退症的关系。我们进行了一项横断面研究，纳入了一家医院的 421 例 CKD 患者，测量了 24 小时尿蛋白排泄（UP）和甲状腺功能检查。Spearman 相关分析显示，24 小时肌酐清除率（24hrCcr）与游离三碘甲状腺原氨酸呈正相关（r = 0.273，p < 0.001），而 UP 与之呈负相关（r = - 0.207，p < 0.001）。根据 CKD 分期和 UP 分层的甲状腺功能减退症频率分布分析显示，CKD 分期较高和肾病范围蛋白尿患者中甲状腺功能减退症的患病率较高。多变量逻辑回归分析显示，24hrCcr 和 UP 与甲状腺功能减退症显著相关（24hrCcr/10 mL/min 降低：比值比 [OR]，1.29；95%置信区间 [CI]，1.18-1.41；UP/1 g 增加：OR，1.10；95% CI，1.03-1.17）。此外，与 UP < 0.5 g/天相比，肾病范围蛋白尿，而不是中度 UP（UP：1.5-3.49 g/天），与甲状腺功能减退症显著相关。总之，肾功能下降和肾病范围蛋白尿，而不是非肾病范围蛋白尿，与甲状腺功能减退症独立相关。
