甲状腺功能减退患者血清同型半胱氨酸与肾功能的关联：伊朗东北部的一项病例对照研究。

Association between serum homocysteine and kidney function in hypothyroid patients: A case-control study in Northeast Iran.

作者信息

Faisal Tamara Nagem, Gholipour Mahin, Sadani Somayyeh, Asadi Jahanbakhsh

机构信息

Department of Clinical Biochemistry, School of Medical Sciences, Golestan University of Medical Sciences, Gorgan, Iran.

Golestan Rheumatology Research Center, Golestan University of Medical Sciences, Gorgan, Iran.

出版信息

Biochem Biophys Rep. 2025 Jul 26;43:102176. doi: 10.1016/j.bbrep.2025.102176. eCollection 2025 Sep.

DOI:10.1016/j.bbrep.2025.102176

PMID:40761373

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12320090/

Abstract

BACKGROUND/OBJECTIVES: The relationship between serum homocysteine (Hcy) and kidney function in hypothyroidism is not fully understood. This case-control study investigated the association of hyperhomocysteinemia (HHcy) with kidney function tests in patients diagnosed with clinical hypothyroidism (CH).

METHODS

Forty-five CH cases and 45 matched controls were recruited from a referral clinic in northeast Iran. Serum Hcy was measured using ELISA technology, and Spearman's correlation coefficients were estimated to assess the association between Hcy and various kidney function parameters.

RESULTS

In CH patients, the average Hcy level was significantly higher than in those with normal thyroid function (22.63 ± 1.21 vs 12.96 ± 0.24 μmol/L, p = 0.001). Among CH patients, 82.2 % had HHcy (60 % mild, 12.2 % moderate), while only 13.3 % of controls had mild HHcy. Hcy levels were positively correlated with TSH (r = 0.528; p = 0.001), eGFR (r = - 0.418; p = 0.004), urea (r = 0.371; p = 0.012), and creatinine (r = 0.384; p = 0.009) in CH patients. Multivariate logistic regression revealed a significant relationship between Hcy and CH [OR = 2.01, 95 % CI: 1.48-2.72, p = 0.001], even after adjusting for kidney parameters.

CONCLUSIONS

Serum Hcy was increased with progressive thyroid insufficiency, independent of changes in kidney function, and could be considered a potential risk factor for developing coronary heart disease.

摘要

背景/目的：甲状腺功能减退症患者血清同型半胱氨酸（Hcy）与肾功能之间的关系尚未完全明确。本病例对照研究调查了临床甲状腺功能减退症（CH）患者高同型半胱氨酸血症（HHcy）与肾功能检查之间的关联。

方法

从伊朗东北部的一家转诊诊所招募了45例CH病例和45例匹配的对照。采用酶联免疫吸附测定（ELISA）技术测定血清Hcy，并估计Spearman相关系数以评估Hcy与各种肾功能参数之间的关联。

结果

CH患者的平均Hcy水平显著高于甲状腺功能正常者（22.63±1.21 vs 12.96±0.24μmol/L，p = 0.001）。在CH患者中，82.2%患有HHcy（60%为轻度，12.2%为中度），而对照组中只有13.3%患有轻度HHcy。CH患者的Hcy水平与促甲状腺激素（TSH）呈正相关（r = 0.528；p = 0.001），与估算肾小球滤过率（eGFR）呈负相关（r = -0.418；p = 0.004），与尿素呈正相关（r = 0.371；p = 0.012），与肌酐呈正相关（r = 0.384；p = 0.009）。多因素逻辑回归显示，即使在调整肾脏参数后，Hcy与CH之间仍存在显著关系[比值比（OR）= 2.01，95%置信区间（CI）：1.48 - 2.72，p = 0.001]。