Chen Zhuang, Feng Jing, Wang Quanxin, Zhu Ling, Yu Anzhong, Liang Shimin, Li Jian, Zhang Shiliang, Wu Feng
The First Clinical Medical College of Shandong University of Chinese Medicine, Jinan, Shandong, P.R. China.
Department of Cardiovascular Medicine, The Fifth People's Hospital of Jinan, Jinan, Shandong, P.R. China.
Clin Appl Thromb Hemost. 2025 Jan-Dec;31:10760296251335246. doi: 10.1177/10760296251335246. Epub 2025 Apr 16.
To study the link between free thyroxine (FT4) levels and mortality in hypertensive patients. Utilizing data from the National Health and Nutrition Examination Survey performed in the United States from 2007 to 2012. This study included 3365 adults from the National Health and Nutrition Examination Survey (NHANES) 2007-2012. Weighted Cox regression model, Kaplan-Meier (KM) survival analysis, and restricted cubic spline (RCS) were used to analyze the link between FT4 levels and mortality in hypertensive patients. Furthermore, subgroup analyses and interaction analyses were carried out to evaluate the stability of links between FT4 levels and all-cause mortality across different subgroups of hypertensive patients. In the weighted Cox regression model, after adjusting for all covariates, FT4 levels treated as a continuous variable were positively linked to all-cause mortality in hypertensive patients (HR = 1.08,95% CI: 1.04-1.12, < .001). When FT4 levels were treated as a categorical variable according to quartiles, the fully adjusted model found that the highest quartile of FT4 posed a greater all-cause mortality risk in hypertensive patients relative to the lowest quartile (HR = 1.47, 95% CI:1.01-2.15, = .045). Based on the Kaplan-Meier survival curve, all-cause mortality was notably higher in groups Q3 and Q4 relative to FT4 levels in groups Q1 and Q2 (< .001). The RCS curve revealed that the all-cause mortality in hypertensive patients exhibited a nonlinear increasing trend with rising FT4 levels ( for nonlinear = .033). The results were further validated by subgroup and sensitivity analyses, which confirmed their robustness and reliability. The level of FT4 is strongly linked to the all-cause mortality risk in hypertensive patients.
研究高血压患者游离甲状腺素(FT4)水平与死亡率之间的联系。利用2007年至2012年在美国进行的国家健康和营养检查调查的数据。本研究纳入了2007 - 2012年国家健康和营养检查调查(NHANES)中的3365名成年人。采用加权Cox回归模型、Kaplan - Meier(KM)生存分析和受限立方样条(RCS)分析高血压患者FT4水平与死亡率之间的联系。此外,进行亚组分析和交互分析以评估高血压患者不同亚组中FT4水平与全因死亡率之间联系的稳定性。在加权Cox回归模型中,在调整所有协变量后,将FT4水平视为连续变量时,其与高血压患者的全因死亡率呈正相关(HR = 1.08,95%CI:1.04 - 1.12,P <.001)。当根据四分位数将FT4水平视为分类变量时,完全调整模型发现,相对于最低四分位数,FT4最高四分位数的高血压患者全因死亡风险更高(HR = 1.47,95%CI:1.01 - 2.15,P =.045)。基于Kaplan - Meier生存曲线,相对于FT4水平处于第1组和第2组,第3组和第4组的全因死亡率显著更高(P <.001)。RCS曲线显示,高血压患者的全因死亡率随FT4水平升高呈非线性上升趋势(非线性检验P = 0.033)。亚组分析和敏感性分析进一步验证了结果,证实了其稳健性和可靠性。FT4水平与高血压患者的全因死亡风险密切相关。