Cargando…
Low glomerular filtration rate values are associated with higher TSH in an elderly population at high cardiovascular disease risk
BACKGROUND: Hypothyroidism is associated with impaired glomerular filtration rate (GFR), a recognized cardiovascular disease (CVD), and mortality risk factor. In older adults, this association remains unexplored. We aimed to determine the relationship of elevated TSH with GFR in an elderly populatio...
Autores principales: | , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10469594/ https://www.ncbi.nlm.nih.gov/pubmed/37664833 http://dx.doi.org/10.3389/fendo.2023.1162626 |
_version_ | 1785099475955482624 |
---|---|
author | Brenta, Gabriela Nepote, Alejandra Barreto, Adriana Musso, Carla Faingold, Cristina Fossati, Pía Antonelli, Alessandro Fallahi, Poupak Famá, Fausto Meroño, Tomás |
author_facet | Brenta, Gabriela Nepote, Alejandra Barreto, Adriana Musso, Carla Faingold, Cristina Fossati, Pía Antonelli, Alessandro Fallahi, Poupak Famá, Fausto Meroño, Tomás |
author_sort | Brenta, Gabriela |
collection | PubMed |
description | BACKGROUND: Hypothyroidism is associated with impaired glomerular filtration rate (GFR), a recognized cardiovascular disease (CVD), and mortality risk factor. In older adults, this association remains unexplored. We aimed to determine the relationship of elevated TSH with GFR in an elderly population at high CVD risk. METHODS: Older adults (age>65ys) with high CVD risk defined by two or more CVD risk factors: smoking (S), high blood pressure (HBP), high total cholesterol, low HDL cholesterol, diabetes (DM), metabolic syndrome or previous cardiovascular event, were prospectively included at our ambulatory Endocrine Clinic. Patients under levothyroxine or thyroid disease were excluded. TSH> 6mU/l defined subclinical hypothyroidism (ScH) with normal free T4 levels. Estimated GFR was calculated by the Berlin-Initiative Study (BIS)-1 formula for elderly population. Urinary albumin to creatinine ratio (uACR), IL-6 and TNF-α, and Carotid intima-media thickness (CIMT) were also determined. The U Mann-Whitney test, the Spearman test, and multiple linear regression were used as statistical tests, RESULTS: Finally 246 patients (68% females) were included and 20 (8%) had ScH. This group, was older (median, Q1-Q3: 77,72-78; 72,68-77 years, p=0.01) and DM was less frequent than in the euthyroid group (35 vs 58%, p=0.039). Lower fasting glucose (-20%,p=0.01), GFR (-14%,p=0.01) and freeT4 (-10%,p<0.001) were found compared to euthyroid patients. A higher prevalence of Kidney failure was found in ScH (80 vs. 46%, p=0.003) vs. euthyroid individuals. Significant correlations with GFR were detected: age (r-0.482,p<0.001), TSH (r-0.172,p=0.004), IL-6 (r-0.150,p=0.047), TNF-α (r-0.274,p<0.001), uACR (r-0.170,p=0.009) and CIMT(r-0.189,p=0.004). By multiple linear regression, in a model adjusted by age, sex, BMI, uACR, S, DM, TNF-α and HBP, TSH (Bst -0.14, p=0.023, R(2) = 0.25) was found an independent predictor of GFR. CONCLUSION: In older adults with high CVD risk, ScH is associated with lower renal function, and this relationship is present regardless of other cardiometabolic risk factors. These results suggest that ScH could contribute to low GFR and excess CVD risk, although this hypothesis should be addressed in longitudinal studies. |
format | Online Article Text |
id | pubmed-10469594 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-104695942023-09-01 Low glomerular filtration rate values are associated with higher TSH in an elderly population at high cardiovascular disease risk Brenta, Gabriela Nepote, Alejandra Barreto, Adriana Musso, Carla Faingold, Cristina Fossati, Pía Antonelli, Alessandro Fallahi, Poupak Famá, Fausto Meroño, Tomás Front Endocrinol (Lausanne) Endocrinology BACKGROUND: Hypothyroidism is associated with impaired glomerular filtration rate (GFR), a recognized cardiovascular disease (CVD), and mortality risk factor. In older adults, this association remains unexplored. We aimed to determine the relationship of elevated TSH with GFR in an elderly population at high CVD risk. METHODS: Older adults (age>65ys) with high CVD risk defined by two or more CVD risk factors: smoking (S), high blood pressure (HBP), high total cholesterol, low HDL cholesterol, diabetes (DM), metabolic syndrome or previous cardiovascular event, were prospectively included at our ambulatory Endocrine Clinic. Patients under levothyroxine or thyroid disease were excluded. TSH> 6mU/l defined subclinical hypothyroidism (ScH) with normal free T4 levels. Estimated GFR was calculated by the Berlin-Initiative Study (BIS)-1 formula for elderly population. Urinary albumin to creatinine ratio (uACR), IL-6 and TNF-α, and Carotid intima-media thickness (CIMT) were also determined. The U Mann-Whitney test, the Spearman test, and multiple linear regression were used as statistical tests, RESULTS: Finally 246 patients (68% females) were included and 20 (8%) had ScH. This group, was older (median, Q1-Q3: 77,72-78; 72,68-77 years, p=0.01) and DM was less frequent than in the euthyroid group (35 vs 58%, p=0.039). Lower fasting glucose (-20%,p=0.01), GFR (-14%,p=0.01) and freeT4 (-10%,p<0.001) were found compared to euthyroid patients. A higher prevalence of Kidney failure was found in ScH (80 vs. 46%, p=0.003) vs. euthyroid individuals. Significant correlations with GFR were detected: age (r-0.482,p<0.001), TSH (r-0.172,p=0.004), IL-6 (r-0.150,p=0.047), TNF-α (r-0.274,p<0.001), uACR (r-0.170,p=0.009) and CIMT(r-0.189,p=0.004). By multiple linear regression, in a model adjusted by age, sex, BMI, uACR, S, DM, TNF-α and HBP, TSH (Bst -0.14, p=0.023, R(2) = 0.25) was found an independent predictor of GFR. CONCLUSION: In older adults with high CVD risk, ScH is associated with lower renal function, and this relationship is present regardless of other cardiometabolic risk factors. These results suggest that ScH could contribute to low GFR and excess CVD risk, although this hypothesis should be addressed in longitudinal studies. Frontiers Media S.A. 2023-08-16 /pmc/articles/PMC10469594/ /pubmed/37664833 http://dx.doi.org/10.3389/fendo.2023.1162626 Text en Copyright © 2023 Brenta, Nepote, Barreto, Musso, Faingold, Fossati, Antonelli, Fallahi, Famá and Meroño https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Endocrinology Brenta, Gabriela Nepote, Alejandra Barreto, Adriana Musso, Carla Faingold, Cristina Fossati, Pía Antonelli, Alessandro Fallahi, Poupak Famá, Fausto Meroño, Tomás Low glomerular filtration rate values are associated with higher TSH in an elderly population at high cardiovascular disease risk |
title | Low glomerular filtration rate values are associated with higher TSH in an elderly population at high cardiovascular disease risk |
title_full | Low glomerular filtration rate values are associated with higher TSH in an elderly population at high cardiovascular disease risk |
title_fullStr | Low glomerular filtration rate values are associated with higher TSH in an elderly population at high cardiovascular disease risk |
title_full_unstemmed | Low glomerular filtration rate values are associated with higher TSH in an elderly population at high cardiovascular disease risk |
title_short | Low glomerular filtration rate values are associated with higher TSH in an elderly population at high cardiovascular disease risk |
title_sort | low glomerular filtration rate values are associated with higher tsh in an elderly population at high cardiovascular disease risk |
topic | Endocrinology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10469594/ https://www.ncbi.nlm.nih.gov/pubmed/37664833 http://dx.doi.org/10.3389/fendo.2023.1162626 |
work_keys_str_mv | AT brentagabriela lowglomerularfiltrationratevaluesareassociatedwithhighertshinanelderlypopulationathighcardiovasculardiseaserisk AT nepotealejandra lowglomerularfiltrationratevaluesareassociatedwithhighertshinanelderlypopulationathighcardiovasculardiseaserisk AT barretoadriana lowglomerularfiltrationratevaluesareassociatedwithhighertshinanelderlypopulationathighcardiovasculardiseaserisk AT mussocarla lowglomerularfiltrationratevaluesareassociatedwithhighertshinanelderlypopulationathighcardiovasculardiseaserisk AT faingoldcristina lowglomerularfiltrationratevaluesareassociatedwithhighertshinanelderlypopulationathighcardiovasculardiseaserisk AT fossatipia lowglomerularfiltrationratevaluesareassociatedwithhighertshinanelderlypopulationathighcardiovasculardiseaserisk AT antonellialessandro lowglomerularfiltrationratevaluesareassociatedwithhighertshinanelderlypopulationathighcardiovasculardiseaserisk AT fallahipoupak lowglomerularfiltrationratevaluesareassociatedwithhighertshinanelderlypopulationathighcardiovasculardiseaserisk AT famafausto lowglomerularfiltrationratevaluesareassociatedwithhighertshinanelderlypopulationathighcardiovasculardiseaserisk AT meronotomas lowglomerularfiltrationratevaluesareassociatedwithhighertshinanelderlypopulationathighcardiovasculardiseaserisk |