Department of Endocrinology, Affiliated Wujin Hospital of Jiangsu University, Changzhou, 213017, Jiangsu, China.
Department of Endocrinology, Wujin Clinical College of Xuzhou Medical University, Changzhou, 213017, Jiangsu, China.
BMC Public Health. 2024 Aug 6;24(1):2134. doi: 10.1186/s12889-024-19660-x.
This study aimed to investigate the association between central sensitivity to thyroid hormones and all-cause mortality in euthyroid patients with chronic kidney disease (CKD).
Data on thyroid function indicators and all-cause mortality for CKD patients were extracted from the NHANES database (2007-2012). Central sensitivities to thyroid hormones were mainly evaluated by Thyroid Feedback Quantile-based Index (TFQI). The Kaplan-Meier method, Cox proportional hazards regression model and subgroup analysis were performed to explore the potential associations between thyroid hormone sensitivity and all-cause mortality.
A total of 1303 euthyroid CKD patients were enrolled in this study. After a median follow-up of 115 months, 503 participants died. The Kaplan-Meier analysis demonstrated significant variations in survival rates among different levels of TFQI (P = 0.0015). Cox regression analysis showed that increased levels of TFQI were independent risk factors for all-cause mortality after adjusting for multiple confounding factors (HR = 1.40, 95% CI 1.10-1.79, P = 0.007). Subgroup analysis did not reveal any significant variation in the association between TFQI and all-cause mortality between the subgroups assessed (P for interaction > 0.05).
Our study suggests that impaired thyroid hormone sensitivity might be linked to increased mortality in euthyroid CKD patients. Further research is needed to confirm and explore this association.
本研究旨在探讨甲状腺激素中枢敏感性与甲状腺功能正常的慢性肾脏病(CKD)患者全因死亡率之间的关系。
从 NHANES 数据库(2007-2012 年)中提取 CKD 患者的甲状腺功能指标和全因死亡率数据。主要通过甲状腺反馈定量指数(TFQI)评估甲状腺激素中枢敏感性。采用 Kaplan-Meier 法、Cox 比例风险回归模型和亚组分析探讨甲状腺激素敏感性与全因死亡率之间的潜在关联。
本研究共纳入 1303 例甲状腺功能正常的 CKD 患者。中位随访 115 个月后,503 名参与者死亡。Kaplan-Meier 分析表明,不同 TFQI 水平的生存率存在显著差异(P = 0.0015)。Cox 回归分析显示,在校正多个混杂因素后,TFQI 水平升高是全因死亡的独立危险因素(HR = 1.40,95% CI 1.10-1.79,P = 0.007)。亚组分析显示,在评估的亚组中,TFQI 与全因死亡率之间的关联没有显著差异(P 交互>0.05)。
本研究提示甲状腺激素敏感性受损可能与甲状腺功能正常的 CKD 患者死亡率升高有关。需要进一步研究来证实和探讨这种关联。