Glomerular filtration rate is associated with free triiodothyronine in euthyroid subjects: Comparison between various equations to estimate renal function and creatinine clearance
Glomerular filtration rate is associated with free triiodothyronine in euthyroid subjects: Comparison between various equations to estimate renal function and creatinine clearance
复制标题
DOI：
10.1016/j.ejim.2017.10.009
复制
发表时间：
2018-02-01
影响因子：
8
通讯作者：
Dullaart, Robin P. F.
中科院分区：
文献类型：
--
作者：
Anderson, Josephine L. C.;Gruppen, Eke G.;Dullaart, Robin P. F.
背景：甲状腺功能正常范围内的甲状腺功能变化对肾功能的影响尚不清楚。基于胱抑素c的估算肾小球滤过率（GFR）的方程目前被提倡用于死亡率和肾脏风险预测。然而，基于胱抑素C的方程不适用于明显甲状腺功能障碍的患者，因为血清胱抑素C和肌酐水平与甲状腺功能障碍相反。在这里，我们比较了促甲状腺激素（TSH）、游离甲状腺素（FT4）和游离三碘甲状腺原氨酸（FT3）与甲状腺功能正常受试者各种肾功能指标的关系。方法：对未使用甲状腺激素、抗甲状腺药物、胺碘酮或碳酸锂的2180例正常甲状腺患者（TSH、FT4、FT3均在参考范围内，抗甲状腺过氧化物酶自身抗体阴性），测定以肌酐（eGFRcrea）、胱抑素C （eGFRcysC）、肌酐+胱抑素C联合（eGFRcrea- cysc）、肌酐清除率（CrCl）为基础的eGFR与TSH、FT4、FT3的关系。结果：在包括TSH、FT3和FT4在内的多变量模型中，eGFRcrea、eGFRcysC、eGFRcrea- cysc和CrCl均与FT3呈正相关（P . 2）
Background: Effects of variations in thyroid function within the euthyroid range on renal function are unclear. Cystatin C-based equations to estimate glomerular filtration rate (GFR) are currently advocated for mortality and renal risk prediction. However, the applicability of cystatin C-based equations is discouraged in patients with overt thyroid dysfunction, since serum cystatin C and creatinine levels are oppositely affected by thyroid dysfunction. Here, we compared relationships of thyroid stimulating hormone (TSH), free thyroxine (FT4) and free triiodothyronine (FT3) with various measures of kidney function in euthyroid subjects.Methods: Relationships of eGFR, based on creatinine (eGFRcrea), cystatin C (eGFRcysC), creatinine + cystatin C combined (eGFRcrea-cysC) and creatinine clearance (CrCl) with TSH, FT4 and FT3 were determined in 2180 euthyroid subjects (TSH, FT4 and FT3 all within the reference range; anti-thyroid peroxidase autoantibodies negative) who did not use thyroid hormones, anti-thyroid drugs, amiodarone or lithium carbonate.Results: In multivariable models including TSH, FT3 and FT4 together, eGFRcrea, eGFRcysC and eGFRcrea-cysC and CrCl were all positively related to FT3 (P