Xu Yin, Wang Xinmei, Wang Guofeng, Wei Wei, Li Ning
Department of Gerontology, The 960th Hospital of PLA, Jinan, China.
Beijing Academy of Military Medical Sciences, China.
Medicine (Baltimore). 2024 Dec 20;103(51):e40925. doi: 10.1097/MD.0000000000040925.
Chronic kidney disease (CKD) and hypothyroidism are prevalent chronic conditions with a generally believed correlation between them. However, large-scale population studies and investigations into causation are lacking. This study analyzed CKD and thyroid function data from the National Health and Nutrition Examination Survey database spanning 2007 to 2012 using multiple regression analyses to examine the correlation between CKD and hypothyroidism. Bidirectional Mendelian randomization analysis was employed to investigate the causal association between the two conditions. As CKD stages deteriorated, there was a significant decrease in total triiodothyronine (TT3) and free triiodothyronine (P < .05). However, no significant decrease was observed in total thyroxine and free thyroxine. Notably, there was a significant increase in thyroid-stimulating hormone levels (P < .05). However, no significant changes were observed in thyroglobulin, thyroglobulin antibody, and thyroid peroxidase antibody levels. A causal relationship between CKD and reduced thyroid function was observed (odds ratio [OR] = 1.0041, 95% confidence interval [CI]: 1.0007-1.0075, P = .0186). Conversely, reverse causality was not statistically significant (OR = 2.540, 95%CI: 0.8680-4.8603, P = .1014). As CKD progressed, the risk of hypothyroidism increased. A causal correlation was observed between CKD and reduced thyroid function. Chronic kidney disease (CKD) and hypothyroidism are prevalent chronic conditions with a generally believed correlation between them. There is no large-scale population studies and the causation relationship between CKD and hypothyroidism are lacking. The finding of the causal relationship between CKD and hypothyroidism may be beneficial to the prevention of the disease and the prognosis of the patients.
慢性肾脏病（CKD）和甲状腺功能减退是常见的慢性疾病，人们普遍认为它们之间存在关联。然而，缺乏大规模的人群研究和病因调查。本研究分析了2007年至2012年美国国家健康与营养检查调查数据库中的CKD和甲状腺功能数据，采用多元回归分析来检验CKD与甲状腺功能减退之间的相关性。采用双向孟德尔随机化分析来研究这两种疾病之间的因果关系。随着CKD分期的恶化，总三碘甲状腺原氨酸（TT3）和游离三碘甲状腺原氨酸显著降低（P<0.05）。然而，总甲状腺素和游离甲状腺素未见显著降低。值得注意的是，促甲状腺激素水平显著升高（P<0.05）。然而，甲状腺球蛋白、甲状腺球蛋白抗体和甲状腺过氧化物酶抗体水平未见显著变化。观察到CKD与甲状腺功能降低之间存在因果关系（优势比[OR]=1.0041，95%置信区间[CI]：1.0007-1.0075，P=0.0186）。相反，反向因果关系无统计学意义（OR=2.540，95%CI：0.8680-4.8603，P=0.1014）。随着CKD的进展，甲状腺功能减退的风险增加。观察到CKD与甲状腺功能降低之间存在因果相关性。慢性肾脏病（CKD）和甲状腺功能减退是常见的慢性疾病，人们普遍认为它们之间存在关联。缺乏大规模的人群研究，且CKD与甲状腺功能减退之间的因果关系尚不明确。CKD与甲状腺功能减退之间因果关系的发现可能有助于疾病的预防和患者的预后。
