Devi D Gayathri, Behera Kishore Kumar, Mangaraj Manaswini, Saharia Gautom Kumar
Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India.
Department of Endocrinology, All India Institute of Medical Sciences (AIIMS), Bhubaneswar Odisha, India.
Front Endocrinol (Lausanne). 2025 Aug 27;16:1572675. doi: 10.3389/fendo.2025.1572675. eCollection 2025.
Elderly population is more susceptible to both hypothyroidism and chronic kidney disease (CKD) independently and it is very crucial to assess kidney function in elderly hypothyroid patients in relation to autoimmunity. There are previous studies showing a correlation between eGFR and TSH, T3, and T4 in the elderly population but no such studies correlating the estimated GFR (eGFR) with the anti-thyroid antibodies of elderly hypothyroid patients are available. This study aimed to assess renal function in newly diagnosed elderly hypothyroid patients and correlate findings with anti-thyroid peroxidase (anti-TPO) levels.
We conducted a cross-sectional study with 128 participants aged 60 years and above after obtaining ethics committee approval. All cases were newly diagnosed patients of hypothyroidism whether clinical or subclinical. The control group consisted of age and sex matched individuals with normal thyroid profile status. Fasting blood samples were collected and serum thyroid parameters, glycemic and renal markers were evaluated, and statistical analyses were performed.
Hypothyroid patients exhibited elevated anti-TPO levels and markers of renal dysfunction, including increased urea, uric acid, and urine albumin/creatinine ratio. Multiple regression analysis identified anti-TPO as an independent predictor of kidney function. Subgroup analysis revealed significantly lower eGFR and elevated renal markers in anti-TPO positive patients.
The interplay between thyroid dysfunction and renal impairment is particularly significant in the elderly, who are more vulnerable to both conditions. Elevated anti-TPO levels are associated with renal dysfunction in elderly hypothyroid patients, suggesting a potential role for anti-TPO in renal impairment.
老年人群独立地更容易患甲状腺功能减退症和慢性肾脏病(CKD),评估老年甲状腺功能减退患者的肾功能与自身免疫的关系非常关键。以往有研究表明老年人群中估算肾小球滤过率(eGFR)与促甲状腺激素(TSH)、三碘甲状腺原氨酸(T3)和甲状腺素(T4)之间存在相关性,但尚无将估算肾小球滤过率(eGFR)与老年甲状腺功能减退患者的抗甲状腺抗体相关联的此类研究。本研究旨在评估新诊断的老年甲状腺功能减退患者的肾功能,并将结果与抗甲状腺过氧化物酶(抗-TPO)水平相关联。
在获得伦理委员会批准后,我们对128名60岁及以上的参与者进行了一项横断面研究。所有病例均为新诊断的甲状腺功能减退患者,无论是临床型还是亚临床型。对照组由年龄和性别匹配、甲状腺功能正常的个体组成。采集空腹血样,评估血清甲状腺参数、血糖和肾脏标志物,并进行统计分析。
甲状腺功能减退患者的抗-TPO水平和肾功能不全标志物升高,包括尿素、尿酸和尿白蛋白/肌酐比值增加。多元回归分析确定抗-TPO是肾功能的独立预测因子。亚组分析显示,抗-TPO阳性患者的eGFR显著降低,肾脏标志物升高。
甲状腺功能障碍与肾功能损害之间的相互作用在老年人中尤为显著,他们更容易患这两种疾病。抗-TPO水平升高与老年甲状腺功能减退患者的肾功能不全有关,提示抗-TPO在肾功能损害中可能起作用。