Neuhaus K, Baumann G, Walser A, Thölen H
J Clin Endocrinol Metab. 1975 Aug;41(2):395-8. doi: 10.1210/jcem-41-2-395.
Total serum thyroxine (T4), free thyroxine index (FTI), thyroxine binding globulin (TBG) binding capacity, serum albumin, alpha-globulins and urinary protein excretion were measured in 50 patients with chronic renal failure, but without nephrotic syndrome. 25 patients were undergoing chronic hemodialysis. T4 was within the normal range in most patients. There was a tendency to lower T4 values as compared to an age and sex-matched control group, but this did not reach statistical significance. TBG was normal in most patients. 4 patients showed elevated TBG concomitant with elevation of other alpha-globulins. Serum albumin was significantly decreased. No correlation existed between daily protein excretion and TBG or alpha-globulins, but the correlation between serum albumin and proteinuria was highly significant. T4 and proteinuria correlated with borderline significance. A highly significant correlation between T4 and TBG-albumin values was found. No correlation existed between FTI and TBG-albumin levels. The data suggest that T4 and TBG are normal in most patients with renal failure, even in the presence of significant proteinuria. Low T4 values, when found in renal insufficiency, may be secondary to low serum albumin and possibly prealbumin.
对50例慢性肾衰竭但无肾病综合征的患者测定了血清总甲状腺素（T4）、游离甲状腺素指数（FTI）、甲状腺素结合球蛋白（TBG）结合能力、血清白蛋白、α球蛋白及尿蛋白排泄量。25例患者正在接受慢性血液透析。大多数患者的T4在正常范围内。与年龄和性别匹配的对照组相比，T4值有降低的趋势，但未达到统计学意义。大多数患者的TBG正常。4例患者TBG升高，同时其他α球蛋白也升高。血清白蛋白显著降低。每日蛋白排泄量与TBG或α球蛋白之间无相关性，但血清白蛋白与蛋白尿之间的相关性非常显著。T4与蛋白尿的相关性接近显著。发现T4与TBG - 白蛋白值之间存在高度显著的相关性。FTI与TBG - 白蛋白水平之间无相关性。数据表明，大多数肾衰竭患者即使存在显著蛋白尿，T4和TBG也是正常的。肾功能不全时发现的低T4值可能继发于低血清白蛋白，也可能继发于前白蛋白降低。
