Unlu Hayrunnisa, Yehia Asmaa, Manji Khalid, Manji Noah, Treviño-Alvarez Andrés M, Cabeza De Baca Tommy, Frye Mark A, Thomas Leslie F, Abulseoud Osama A
Department of Psychiatry and Psychology, Mayo Clinic Arizona, Phoenix, AZ, United States.
Department of Neuroscience, Graduate School of Biomedical Sciences, Mayo Clinic College of Medicine, Phoenix, AZ, United States.
Front Nephrol. 2024 Aug 8;4:1322791. doi: 10.3389/fneph.2024.1322791. eCollection 2024.
Despite a well-established direct toxic effect of alcohol on renal cells, there is a salutary dose-dependent effect of alcohol consumption on common laboratory parameters related to kidney performance. Alcohol also impacts thyroid hormones, while thyroid status modulates kidney function. The modulation of kidney parameters with thyrotropin (TSH) and thyroid status indicates a possible interaction between alcohol, kidney, and thyroid functions. This retrospective study was conducted to test the hypothesis that the positive effect of alcohol use on the estimated glomerular filtration rate (eGFR) is mediated by alcohol's effect on thyroid hormones.
We reviewed the electronic medical records of 767 hospitalized adult patients free of thyroid disorders who received medical care in the Mayo Clinic Health System from June 2019 through June 2022 and had blood alcohol concentration (BAC), serum TSH, and serum creatinine measured during the hospitalization. We calculated the eGFR using both the re-expressed Modification of Diet in Renal Disease (MDRD II) study equation and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) Creatinine equation.
We found a significant relationship of BAC with eGFR (CKD-EPI) and TSH in males only. BAC had a positive association with eGFR (b = 0.24, p = 0.0001) and negative with TSH (b=-0.17, p = 0.006). The covariance between the two outcomes (eGFR and TSH) was negative (b = -0.12, p = 0.049). The path analyses using the eGFR MDRD II equation were not significant in males, whereas females had no significant path analyses with either of the eGFR equations.
We observed that BAC influences both eGFR and TSH, whereas eGFR and TSH influence each other. After considering important covariates (e.g., age, body mass index, diabetes mellitus, cardiovascular disease, chronic kidney disease, and chronic liver disease) and the negative bidirectional effect of TSH and eGFR, a positive impact of BAC on eGFR was observed in males.
尽管酒精对肾细胞有明确的直接毒性作用，但饮酒对与肾脏功能相关的常见实验室参数存在有益的剂量依赖性效应。酒精还会影响甲状腺激素，而甲状腺状态会调节肾功能。促甲状腺激素（TSH）和甲状腺状态对肾脏参数的调节表明酒精、肾脏和甲状腺功能之间可能存在相互作用。本回顾性研究旨在检验以下假设：饮酒对估计肾小球滤过率（eGFR）的积极作用是由酒精对甲状腺激素的影响介导的。
我们回顾了2019年6月至2022年6月期间在梅奥诊所医疗系统接受治疗的767名无甲状腺疾病的住院成年患者的电子病历，这些患者在住院期间测量了血液酒精浓度（BAC）、血清TSH和血清肌酐。我们使用重新表达的肾脏疾病饮食改良（MDRD II）研究方程和慢性肾脏病流行病学协作（CKD-EPI）肌酐方程计算eGFR。
我们发现仅在男性中，BAC与eGFR（CKD-EPI）和TSH存在显著关系。BAC与eGFR呈正相关（b = 0.24，p = 0.0001），与TSH呈负相关（b = -0.17，p = 0.006）。两个结果（eGFR和TSH）之间的协方差为负（b = -0.12，p = 0.049）。使用eGFR MDRD II方程的路径分析在男性中不显著，而女性使用任何一个eGFR方程的路径分析均不显著。
我们观察到BAC影响eGFR和TSH，而eGFR和TSH相互影响。在考虑重要的协变量（如年龄、体重指数、糖尿病、心血管疾病、慢性肾脏病和慢性肝病）以及TSH和eGFR的负向双向效应后，在男性中观察到BAC对eGFR有积极影响。
