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The association between thyroid hormones and arterial stiffness in peritoneal dialysis patients

  • Nephrology – Original Paper
  • Published:
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Abstract

Background/Aims

The association between thyroid hormones and arterial stiffness is unclear. In this study, we investigated, for the first time in a large cohort of euthyroid peritoneal dialysis patients, the relationship between thyroid hormone levels and arterial stiffness.

Methods

Fifty-seven patients were enrolled. Serum TSH, free T3 and free T4 levels were measured by chemiluminescence immunoassay method. Pulse wave analysis [augmentation index (AIx) and subendocardial viability ratio (SEVR)] were measured to assess arterial stiffness.

Results

Mean age was 49 ± 12.3 years, and 56.1% were female. Mean TSH, fT3 and fT4 levels were 1.97 ± 0.99 mIU/ml, 2.80 ± 0.42 pg/ml and 1.22 ± 0.16 ng/dl, respectively. Mean AIx and SEVR were 22.3 ± 11.3 and 136 ± 21%, respectively. AIx was negatively correlated with residual urine volume (r = −0.372, P: 0.03) and fT3 levels (r = −0.382, P: 0.005). SEVR was correlated only with TSH level (r = −0.394, P: 0.003). In linear regression analysis adjusted for age, gender, history of diabetes and cardiovascular disease and residual diuresis, fT3 level (t = −3.949, P < 0.001) remained associated with AIx. Only TSH level (t = −2.409, P: 0.02) was related to SEVR.

Conclusion

Low serum fT3 level is associated with arterial stiffness, and high TSH level within the normal range is related to lower SEVR in euthyroid PD patients.

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References

  1. Vanholder R, Massy Z, Argiles A et al (2005) Chronic kidney disease as cause of cardiovascular morbidity and mortality. Nephrol Dial Transplant 20(6):1048–1056

    Article  PubMed  CAS  Google Scholar 

  2. Van der Zee S, Baber U, Elmariah S et al (2009) Cardiovascular risk factors in patients with chronic kidney disease. Nat Rev Cardiol 6(9):580–589

    Article  PubMed  Google Scholar 

  3. Blacher J, Pannier B, Guerin AP et al (1998) Carotid arterial stiffness as a predictor of cardiovascular and all-cause mortality in end-stage renal disease. Hypertension 32(3):570–574

    PubMed  CAS  Google Scholar 

  4. Blacher J, Guerin AP, Pannier B et al (1999) Impact of aortic stiffness on survival in end-stage renal disease. Circulation 99(18):2434–2439

    PubMed  CAS  Google Scholar 

  5. Covic A, Gusbeth-Tatomir P, Goldsmith DJ (2005) Arterial stiffness in renal patients: an update. Am J Kidney Dis 45(6):965–977

    Article  PubMed  Google Scholar 

  6. Iglesias P, Díez JJ (2009) Thyroid dysfunction and kidney disease. Eur J Endocrinol 160(4):503–515

    Article  PubMed  CAS  Google Scholar 

  7. Lo JC, Chertow GM, Go AS et al (2005) Increased prevalence of subclinical and clinical hypothyroidism in persons with chronic kidney disease. Kidney Int 67(3):1047–1052

    Article  PubMed  Google Scholar 

  8. Van der Poll T, Romijn JA, Wiersinga WM et al (1990) Tumor necrosis factor: a putative mediator of the sick euthyroid syndrome in man. J Clin Endocrinol Metab 71(6):1567–1572

    Article  PubMed  Google Scholar 

  9. Bartalena L, Brogioni S, Grasso L et al (1994) Relationship of the increased serum interleukin-6 concentration to changes of thyroid function in nonthyroidal illness. J Endocrinol Invest 17(4):269–274

    PubMed  CAS  Google Scholar 

  10. Corssmit EP, Heyligenberg R, Endert E et al (1995) Acute effects of interferon-alpha administration on thyroid hormone metabolism in healthy men. J Clin Endocrinol Metab 80(11):3140–3144

    Article  PubMed  CAS  Google Scholar 

  11. Nagaya T, Fujieda M, Otsuka G et al (2000) A potential role of activated NF-kappa B in the pathogenesis of euthyroid sick syndrome. J Clin Invest 106(3):393–402

    Article  PubMed  CAS  Google Scholar 

  12. Cappola AR, Ladenson PW (2003) Hypothyroidism and atherosclerosis. J Clin Endocrinol Metab 88(6):2438–2444

    Article  PubMed  CAS  Google Scholar 

  13. Imaizumi M, Akahoshi M, Ichimaru S et al (2004) Risk for ischemic heart disease and all-cause mortality in subclinical hypothyroidism. J Clin Endocrinol Metab 89(7):3365–3370

    Article  PubMed  CAS  Google Scholar 

  14. Pingitore A, Landi P, Taddei MC et al (2005) Triiodothyronine levels for risk stratification of patients with chronic heart failure. Am J Med 118(2):132–136

    Article  PubMed  CAS  Google Scholar 

  15. Iervasi G, Pingitore A, Landi P et al (2003) Low-T3 syndrome: a strong prognostic predictor of death in patients with heart disease. Circulation 107(5):708–713

    Article  PubMed  Google Scholar 

  16. Zoccali C, Mallamaci F, Tripepi G et al (2006) Low triiodothyronine and survival in end-stage renal disease. Kidney Int 70(3):523–528

    Article  PubMed  CAS  Google Scholar 

  17. Ozen KP, Asci G, Gungor O et al (2011) Nutritional state alters the association between free triiodothyronine levels and mortality in hemodialysis patients. Am J Nephrol 33(4):305–312

    Article  PubMed  CAS  Google Scholar 

  18. Carrero JJ, Qureshi AR, Axelsson J et al (2007) Clinical and biochemical implications of low thyroid hormone levels (total and free forms) in euthyroid patients with chronic kidney disease. J Intern Med 262(6):690–701

    Article  PubMed  CAS  Google Scholar 

  19. Shinohara K, Shoji T, Tsujimoto Y et al (2004) Arterial stiffness in predialysis patients with uremia. Kidney Int 65(3):936–943

    Article  PubMed  Google Scholar 

  20. Guérin AP, London GM, Marchais SJ et al (2000) Arterial stiffening and vascular calcifications in end-stage renal disease. Nephrol Dial Transplant 15:1014–1021

    Article  PubMed  Google Scholar 

  21. Haydar AA, Covic A, Colhoun H et al (2004) Coronary artery calcification and aortic pulse wave velocity in chronic kidney disease patients. Kidney Int 65(5):1790–1794

    Article  PubMed  Google Scholar 

  22. Huang WH, Chen KH, Hsu CW et al (2008) Residual renal function–one of the factors associated with arterial stiffness in peritoneal dialysis patients. Insight from a retrospective study in 146 peritoneal dialysis patients. Blood Purif 26(2):133–137

    Article  PubMed  Google Scholar 

  23. Fassett RG, Driver R, Healy H et al (2009) Comparison of markers of oxidative stress, inflammation and arterial stiffness between incident hemodialysis and peritoneal dialysis patients–an observational study. BMC Nephrol 12(10):8

    Article  Google Scholar 

  24. Klein I, Ojamaa K (2001) Thyroid hormone and the cardiovascular system. N Engl J Med 344(7):501–509

    Article  PubMed  CAS  Google Scholar 

  25. Ojamaa K, Klemperer JD, Klein I (1996) Acute effects of thyroid hormone on vascular smooth muscle. Thyroid 6(5):505–512

    Article  PubMed  CAS  Google Scholar 

  26. Yilmaz MI, Sonmez A, Karaman M et al (2011) Low triiodothyronine alters flow-mediated vasodilatation in advanced nondiabetic kidney disease. Am J Nephrol 33:25–32

    Article  PubMed  CAS  Google Scholar 

  27. Tatar E, Kircelli F, Asci G, et al. (2011) Associations of triiodothyronine levels with carotid atherosclerosis and arterial stiffness in hemodialysis patients. Clin J Am Soc Nephrol. doi:10.2215/CJN.02540311

  28. Zimmermann J, Herrlinger S, Pruy A et al (1999) Inflammation enhances cardiovascular risk and mortality in hemodialysis patients. Kidney Int 55(2):648–658

    Article  PubMed  CAS  Google Scholar 

  29. Yeun JY, Levine RA, Mantadilok V et al (2000) C-reactive protein predicts all-cause and cardiovascular mortality in hemodialysis patients. Am J Kidney Dis 35(3):469–476

    Article  PubMed  CAS  Google Scholar 

  30. Zoccali C, Tripepi G, Cutrupi S et al (2005) Low triiodothyronine: a new facet of inflammation in end-stage renal disease. J Am Soc Nephrol 16(9):2789–2795

    Article  PubMed  CAS  Google Scholar 

  31. Kaptein EM, Weiner JM, Robinson WJ et al (1982) Relationship of altered thyroid hormone indices to survival in nonthyroidal illnesses. Clin Endocrinol (Oxf) 16(6):565–574

    Article  CAS  Google Scholar 

  32. Boelen A, Platvoet-ter Schiphorst MC, Wiersinga WM (1995) Soluble cytokine receptors and the low 3, 5, 3-triiodothyronine syndrome in patients with nonthyroidal disease. J Clin Endocrinol Metab 80(3):971–976

    Article  PubMed  CAS  Google Scholar 

  33. Brazier J, Cooper N, Buckberg G (1974) The adequacy of subendocardial oxygen delivery. Circulation 49(5):968–977

    PubMed  CAS  Google Scholar 

  34. Hayward CS, Kelly RP (1997) Gender-related differences in the central arterial pressure waveform. J Am Coll Cardiol 30(7):1863–1871

    Article  PubMed  CAS  Google Scholar 

  35. Yun KH, Jeong MH, Oh SK et al (2007) Relationship of thyroid stimulating hormone with coronary atherosclerosis in angina patients. Int J Cardiol 122(1):56–60

    Article  PubMed  Google Scholar 

  36. Auer J, Berent R, Weber T et al (2003) Thyroid function is associated with presence and severity of coronary atherosclerosis. Clin Cardiol 26(12):569–573

    Article  PubMed  CAS  Google Scholar 

  37. Asvold BO, Bjøro T, Nilsen TI et al (2008) Thyrotropin levels and risk of fatal coronary heart disease: the HUNT study. Arch Intern Med 168(8):855–860

    Article  PubMed  Google Scholar 

  38. Kang EW, Nam JY, Yoo TH et al (2008) Clinical implications of subclinical hypothyroidism in continuous ambulatory peritoneal dialysis patients. Am J Nephrol 28(6):908–913

    Article  PubMed  CAS  Google Scholar 

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Acknowledgments

The authors would like to thank Dr. Adrian Covic for his peer review of the manuscript and the nurses at the PD Unit at Ege University for their help in collection of data.

Conflict of Interest

The authors declare no conflict of interest.

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Authors and Affiliations

  1. Division of Nephrology, Ege University School of Medicine, 35100, Bornova, Izmir, Turkey

    Erhan Tatar, Meltem Sezis Demirci, Fatih Kircelli, Ozkan Gungor, Mustafa Yaprak, Gulay Asci, Ali Basci, Mehmet Ozkahya & Ercan Ok

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  1. Erhan Tatar
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  2. Meltem Sezis Demirci
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Correspondence to Erhan Tatar.

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Tatar, E., Sezis Demirci, M., Kircelli, F. et al. The association between thyroid hormones and arterial stiffness in peritoneal dialysis patients. Int Urol Nephrol 44, 601–606 (2012). https://doi.org/10.1007/s11255-011-0034-7

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  • DOI: https://doi.org/10.1007/s11255-011-0034-7

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