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Luo X, Xiao S, Huang D, Guo E, Yang Y, Qiu X, Wang X, Qian Z, Vaughn MG, Bingheim E, Dong G, Liu S, Zeng X. Associations between urinary rare Earth elements with renal function: Findings from a cross-sectional study in Guangxi, China. J Trace Elem Med Biol 2024; 85:127461. [PMID: 38986394 DOI: 10.1016/j.jtemb.2024.127461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 04/07/2024] [Accepted: 04/17/2024] [Indexed: 07/12/2024]
Abstract
BACKGROUND With increased applications of rare earth elements (REEs) across various industries, evaluating the relationship between REEs exposure and potential health effects has become a public concern. In vivo experiments have established that REEs impact renal function. However, relevant epidemiological evidence on this relationship remains scarce. The objective of this study is to examine the impact of exposure to REEs on renal function. METHODS In this cross-sectional study, 1052 participants were recruited from Guangxi, China. We measured urinary concentrations of 12 REEs using an inductively coupled plasma-mass spectrometer (ICP-MS). Multiple linear regression models were developed to explore the relationship between a single REEs exposure and the estimated glomerular filtration rate (eGFR), a marker of renal function. Weighted quantile sum (WQS) regression and Bayesian kernel machine regression (BKMR) were used to examine the combined effects of REE co-exposure on eGFR. RESULTS In the multiple linear regression analysis, increasing the concentrations of lanthanum (La, β: 8.22, 95% CI: 5.67-10.77), cerium (Ce, β:6.61, 95% CI: 3.80-9.43), praseodymium (Pr, β: 8.46, 95% CI: 5.85-11.07), neodymium (Nd, β:8.75, 95% CI: 6.10-11.41), and dysprosium (Dy, β:7.38, 95% CI: 4.85-9.91) significantly increased the eGFR. In the WQS regression model, the WQS index was significantly associated with eGFR (β: 4.03, 95% CI: 2.46-5.60), with Pr having the strongest correlation with eGFR. Similar results were obtained in the BKMR model. Additionally, interactions between Pr and La, and Pr and Nd were observed. CONCLUSIONS Co-exposure to REEs is positively associated with elevated eGFR. Pr is likely to have the most significant influence on increased eGFRs and this might be exacerbated when interacting with La and Nd. Mixed exposure to low doses of REEs had a protective effect on renal function, which can provide some evidence for the exposure threshold of REEs in the environment. TRIAL REGISTRATION The study has been approved by the Guangxi Medical University Medical Ethics Committee (#20170206-1), and all participants provided written informed consent.
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Affiliation(s)
- Xingxi Luo
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Suyang Xiao
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Dongping Huang
- Department of Sanitary Chemistry, School of Public Health, Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Erna Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Yu Yang
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Xiaoqiang Qiu
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Xiaogang Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Zhengmin Qian
- Department of Epidemiology and Biostatistics, College for Public Health & Social Justice, Saint Louis University, 3545 Lafayette Avenue, Saint Louis, MO 63104, USA
| | - Michael G Vaughn
- Department of Epidemiology and Biostatistics, School of Social Work, Saint Louis University, 3545 Lafayette Avenue, Saint Louis, MO 63104, USA
| | - Elizabeth Bingheim
- Department of Epidemiology and Biostatistics, College for Public Health & Social Justice, Saint Louis University, 3545 Lafayette Avenue, Saint Louis, MO 63104, USA
| | - Guanghui Dong
- Department of Environmental and Occupational Health, School of Public Health, Sun Yat-sen University, 74, Guangzhou 510080, China
| | - Shun Liu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Guangxi Medical University, Nanning, Guangxi 530021, China.
| | - Xiaoyun Zeng
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China.
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Wang S, Wang Y, Sun S, Li F, Zhao W, Li X, Ye M, Niu Y, Wu X. Free triiodothyronine to free thyroxine ratio as a marker of poor prognosis in euthyroid patients with acute coronary syndrome and diabetes after percutaneous coronary intervention. Front Endocrinol (Lausanne) 2024; 15:1322969. [PMID: 38654927 PMCID: PMC11036861 DOI: 10.3389/fendo.2024.1322969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 03/18/2024] [Indexed: 04/26/2024] Open
Abstract
Objectives In recent years, the free triiodothyronine/free thyroxine (FT3/FT4) ratio, a new comprehensive index for evaluating thyroid function, which could reflect thyroid function more stably and truly than serum thyroid hormone level, has been demonstrated to correlate with the risks of diabetes and cardiovascular disease in euthyroid adults. However, the correlation between thyroid hormone sensitivity and long-term prognosis in euthyroid patients with acute coronary syndrome (ACS) and diabetes after percutaneous coronary intervention (PCI) remains unclear. Methods A total of 1,786 euthyroid patients with ACS who successfully underwent PCI at Beijing Anzhen Hospital from August 2021 to April 2022 were included in our study, which was divided into three groups according to tertiles of thyroid hormone sensitivity index. Cox regression, Kaplan-Meier, and receiver operating characteristic analyses were applied to analyze the associations between the FT3/FT4 ratio with ACS and diabetes after PCI. Results Our analysis indicated that a lower level of FT3/FT4 ratio in euthyroid patients with acute coronary syndrome (ACS) and diabetes after PCI showed significantly higher incidences of major adverse cardiac and cerebrovascular events (MACCE) when compared with a higher level of FT3/FT4 ratio. After adjusting for other covariates, patients with a lower level of FT3/FT4 ratio were negatively associated with the risk of MACCE than those with a higher level of FT3/FT4 ratio (adjusted OR =1.61, 95% CI 1.05-2.47, P = 0.028). In subgroup analyses, individuals were stratified by age, sex, BMI, ACS type, hypertension, and dyslipidemia, showing that there were no significant interactions between the FT3/FT4 ratio and all subgroups for MACCE. In addition, the FT3/FT4 ratio performed better on ROC analyses for cardiac death prediction [area under the curve (AUC), 0.738]. Conclusion A reduced level of FT3/FT4 ratio was a potential marker of poor prognosis in euthyroid patients with ACS and diabetes after PCI.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Xiaofan Wu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
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Liu ZX, Lv JL, Xiang YL, Deng W, Huang H, Sun YH, Li LH. The Association Between Thyroid Hormones and Renal Function in Euthyroid Chinese Individuals: A Population-Based Cross-Sectional Study. Cureus 2024; 16:e55682. [PMID: 38586713 PMCID: PMC10997831 DOI: 10.7759/cureus.55682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2024] [Indexed: 04/09/2024] Open
Abstract
Objective This population-based cross-sectional study aimed to investigate the association between thyroid hormones and renal function in euthyroid Chinese individuals, as the relationship between thyroid hormones and renal function in this population remains unclear. Methods A total of 661 participants were included in the study after excluding individuals with thyroid diseases, incomplete clinical measurements, or those taking medications affecting thyroid function. Participants were categorized into three groups based on serum thyroid hormone and antibody levels. The study adjusted for covariates and assessed the glomerular filtration rate (GFR) and urine albumin-to-creatinine ratio (ACR) in relation to thyroid hormone levels. Results After adjusting for covariates, the study found a significant increase in GFR in the middle and highest tertiles of free triiodothyronine (FT3) and the highest tertile of total triiodothyronine (TT3). Serum FT3 and TT3 levels were significantly associated with GFR. Additionally, the study observed a significantly lower GFR in the highest tertile of thyroid-stimulating hormone (TSH) compared to the lowest tertile. However, thyroid hormone and antibody levels were not associated with the ACR. Furthermore, the highest tertiles of TT3 and total thyroxine (TT4) were associated with a decreased risk of chronic kidney disease (CKD). Conclusion In our study among euthyroid Chinese individuals, we observed a significant association between thyroid function and GFR. Specifically, lower FT3, TT3, and higher TSH were associated with reduced GFR, indicating a potential role for thyroid hormones in maintaining renal function. Furthermore, lower levels of TT3 and TT4 were associated with an increased risk of CKD. These findings suggest a direct link between thyroid and renal function, even in euthyroid individuals, emphasizing the need for further investigation to elucidate the underlying mechanisms and potential therapeutic implications.
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Affiliation(s)
- Zheng-Xin Liu
- Department of Gerontology, The First Affiliated Hospital of Dali University, Dali, CHN
| | - Jin-Lin Lv
- Department of Gerontology, The First Affiliated Hospital of Dali University, Dali, CHN
| | - Yu-Luan Xiang
- Department of Gerontology, The First Affiliated Hospital of Dali University, Dali, CHN
| | - Wenbin Deng
- Department of Gerontology, The First Affiliated Hospital of Dali University, Dali, CHN
| | - Hong Huang
- Department of Gerontology, The First Affiliated Hospital of Dali University, Dali, CHN
| | - Yin-Hua Sun
- Department of Gerontology, The First Affiliated Hospital of Dali University, Dali, CHN
| | - Li-Hua Li
- Department of Gerontology, The First Affiliated Hospital of Dali University, Dali, CHN
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Di Bonito P, Corica D, Marzuillo P, Di Sessa A, Licenziati MR, Faienza MF, Calcaterra V, Franco F, Maltoni G, Valerio G, Wasniewska M. Sensitivity to Thyroid Hormones and Reduced Glomerular Filtration in Children and Adolescents with Overweight or Obesity. Horm Res Paediatr 2023; 97:383-387. [PMID: 37812927 PMCID: PMC11251643 DOI: 10.1159/000534472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 09/30/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND Reduced central sensitivity to thyroid hormones (THs) has been observed in euthyroid adults with reduced renal function. This topic is unexplored in young people with overweight or obesity (OW/OB). OBJECTIVE The aim of this study was to evaluate the association between sensitivity to TH and mild reduced estimated glomerular filtration rate (MReGFR) in euthyroid children and adolescents with OW/OB. METHODS Data of 788 euthyroid children and adolescents with OW/OB (aged 6-16 years), recruited from seven Italian centers for the care of OW/OB, were evaluated. Peripheral sensitivity to TH was estimated through the FT3/FT4 ratio, while central sensitivity was assessed by estimating TSH index (TSHI), thyrotroph T4 resistance index, thyroid feedback quantile-based index (TFQI), parametric thyroid feedback quantile-based index (PTFQI). MReGFR was defined by an eGFR value ≥60 and <90 mL/min/1.73 m2. RESULTS Subjects with MReGFR had significantly lower levels of FT3/FT4 ratio (0.43 ± 0.09 vs. 0.44 ± 0.10; p = 0.028) and higher levels of TSH (2.89 ± 1.00 vs. 2.68 ± 0.99; p = 0.019), TSHI (2.95 ± 0.45 vs. 2.85 ± 0.55; p = 0.031), TFQI [1.00 (0.98-1.00) versus 1.00 (0.97-1.00); p = 0.046], and PTFQI (0.66 ± 0.17 vs. 0.60 ± 0.23; p = 0.006) compared with individuals with normal eGFR. Odds ratio of MReGFR raised of 1.2-3.2-fold for each increase of 1 mIU/L in TSH, 1 unit in TSHI, and PTFQI, but not for FT3/FT4 ratio. CONCLUSION MReGFR is associated with reduced indices of central sensitivity to TH in euthyroid children and adolescents with OW/OB. This preliminary observation should be confirmed in prospective studies.
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Affiliation(s)
- Procolo Di Bonito
- Department of Internal Medicine, “S. Maria delle Grazie” Hospital, Pozzuoli, Italy
| | - Domenico Corica
- Department of Human Pathology of Adulthood and Childhood, University of Messina, Messina, Italy
| | - Pierluigi Marzuillo
- Department of Woman, Child and of General and Specialized Surgery, University of Campania “Luigi Vanvitelli,” Napoli, Italy
| | - Anna Di Sessa
- Department of Woman, Child and of General and Specialized Surgery, University of Campania “Luigi Vanvitelli,” Napoli, Italy
| | - Maria Rosaria Licenziati
- Neuro-Endocrine Diseases and Obesity Unit, Department of Neurosciences, Santobono-Pausilipon Children’s Hospital, Napoli, Italy
| | - Maria Felicia Faienza
- Department of Precision and Regenerative Medicine and Ionian Area, University of Bari “Aldo Moro,” Bari, Italy
| | - Valeria Calcaterra
- Pediatric Department, Buzzi Children’s Hospital, Milan, Italy
- Department of Internal Medicine, University of Pavia, Pavia, Italy
| | - Francesca Franco
- Pediatric Department, Azienda Sanitaria Universitaria Friuli Centrale, Hospital of Udine, Udine, Italy
| | - Giulio Maltoni
- Pediatric Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Giuliana Valerio
- Department of Movement Sciences and Wellbeing, University of Napoli “Parthenope,” Napoli, Italy
| | - Malgorzata Wasniewska
- Department of Human Pathology of Adulthood and Childhood, University of Messina, Messina, Italy
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Post A, Garcia E, Gruppen EG, Kremer D, Connelly MA, Bakker SJL, Dullaart RPF. Higher Free Triiodothyronine Is Associated With Higher HDL Particle Concentration and Smaller HDL Particle Size. J Clin Endocrinol Metab 2022; 107:e1807-e1815. [PMID: 35106588 PMCID: PMC9016450 DOI: 10.1210/clinem/dgac044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Indexed: 11/23/2022]
Abstract
CONTEXT Thyroid function status has effects on the development of atherosclerotic cardiovascular disease by affecting lipid metabolism, but associations of high-density lipoprotein (HDL) particle concentrations and subfractions with thyroid hormone levels within the reference range remain elusive. OBJECTIVE The aim of the present study was to determine the associations of free triiodothyronine (FT3), free thyroxine (FT4) and thyroid-stimulating hormone (TSH) levels with HDL particle characteristics in euthyroid individuals. METHODS This cross-sectional study on the associations of thyroid hormones with HDL particle concentrations, HDL subfractions, and HDL particle size included 5844 euthyroid individuals (FT3, FT4, and TSH levels within the reference range and no medication use affecting thyroid function), participating in the Prevention of REnal and Vascular ENd-stage Disease (PREVEND) study. HDL particles and subfractions were measured by nuclear magnetic resonance using an optimized version of the NMR LipoProfile Test (LP4). RESULTS In multivariable linear regression analyses, FT3 was positively associated with total HDL particle concentration (std.β = 0.14; P < 0.001) and with small (std.β = 0.13; P < 0.001) and medium-sized HDL particles (std.β = 0.05; P = 0.001). Conversely, FT3 was inversely associated with large HDL particles (std.β = -0.07; P < 0.001) and with HDL particle size (std.β = -0.08; P < 0.001). Such associations with FT4 or reciprocally with TSH were less pronounced or nonsignificant. CONCLUSION In euthyroid individuals, higher FT3 is cross-sectionally associated with higher total HDL particle concentration and with lower HDL particle size. These associations may be relevant to better understand the role of HDL in thyroid function-associated atherosclerotic cardiovascular disease.
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Affiliation(s)
- Adrian Post
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands
| | - Erwin Garcia
- Laboratory Corporation of America Holdings (Labcorp), Morrisville, NC 27560, USA
| | - Eke G Gruppen
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands
| | - Daan Kremer
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands
| | - Margery A Connelly
- Laboratory Corporation of America Holdings (Labcorp), Morrisville, NC 27560, USA
| | - Stephan J L Bakker
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands
| | - Robin P F Dullaart
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands
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Shimizu Y, Kawashiri SY, Noguchi Y, Nakamichi S, Nagata Y, Hayashida N, Maeda T. Associations among Ratio of Free Triiodothyronine to Free Thyroxine, Chronic Kidney Disease, and Subclinical Hypothyroidism. J Clin Med 2022; 11:jcm11051269. [PMID: 35268361 PMCID: PMC8911058 DOI: 10.3390/jcm11051269] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/19/2022] [Accepted: 02/22/2022] [Indexed: 02/05/2023] Open
Abstract
The ratio of free triiodothyronine (FT3) to free thyroxine (FT4) (FT3/FT4), a maker of peripheral thyroxin deiodination, could indicate activity of thyroid hormone. Since positive association between subclinical hypothyroidism (SCH) and chronic kidney disease (CKD) was reported, clarifying the association among FT3/FT4, SCH, and CKD could be an efficient tool to make a strategy for preventing CKD. A cross-sectional study with 1724 Japanese with normal thyroid hormone was conducted. Significant positive association between SCH and CKD was observed; the adjusted odds ratio (OR) and 95% confidence interval (95% CI) was 2.23 (1.38, 3.59). Even though, FT3/FT4 was found to be inversely associated with CKD whereas positively associated with SCH; the adjusted ORs and 95% CIs for 1 standard deviation (SD) increment of FT3/FT4 were 0.51 (0.35, 0.74) for CKD and 2.40 (1.34, 4.29) for SCH, respectively. FT3/FT4 was also found to be positively associated with SCH without CKD but not those with CKD; 1 SD increment of FT3/FT4 were 3.44 (1.72, 6.91) for SCH without CKD and 1.11 (0.40, 3.06) for SCH with CKD, respectively. Although further investigation is necessary, present study indicates that higher activity of peripheral thyroxin deiodination might have beneficial association on absence of CKD even among SCH which is positively associated with CKD.
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Affiliation(s)
- Yuji Shimizu
- Department of General Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan;
- Department of Cardiovascular Disease Prevention, Osaka Center for Cancer and Cardiovascular Diseases Prevention, Osaka 537-8511, Japan
- Correspondence: ; Tel.: +81-95-819-7578
| | - Shin-Ya Kawashiri
- Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8523, Japan; (S.-Y.K.); (Y.N.); (Y.N.)
- Leading Medical Research Core Unit, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8523, Japan;
| | - Yuko Noguchi
- Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8523, Japan; (S.-Y.K.); (Y.N.); (Y.N.)
| | - Seiko Nakamichi
- Nagasaki University Health Center, Nagasaki 852-8523, Japan;
| | - Yasuhiro Nagata
- Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8523, Japan; (S.-Y.K.); (Y.N.); (Y.N.)
- Leading Medical Research Core Unit, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8523, Japan;
| | - Naomi Hayashida
- Leading Medical Research Core Unit, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8523, Japan;
- Division of Promotion of Collaborative Research on Radiation and Environmental Health Effects, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki 852-8523, Japan
| | - Takahiro Maeda
- Department of General Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan;
- Leading Medical Research Core Unit, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8523, Japan;
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Li Y, Lou Q, Wen S, Zhou M, Xu D, Wang C, Liu X, Zhou L. Relationship Between Sporadic Renal Cysts and Renal Function Detected by Isotope Renography in Type 2 Diabetes. Diabetes Metab Syndr Obes 2022; 15:2443-2454. [PMID: 35975275 PMCID: PMC9375979 DOI: 10.2147/dmso.s373120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 08/03/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE This study aimed to reveal the relationship between the volume of sporadic renal cysts and renal function in patients with type 2 diabetes (T2D). MATERIALS AND METHODS One hundred and seventy-one patients that underwent renal imaging and other routine examinations at the Shanghai Pudong Hospital were included in this study. The Gates' method of glomerular filtration rate (GFR) was measured by 99mTc-DTPA renal dynamic imaging in addition to the eGFR, calculated by the Chronic Kidney Disease Epidemiology Collaboration equation (CKD-EPI). RESULTS Our results showed that BMI, total iGFR, and eGFR showed significant differences between patients with T2D with or without SRC (p < 0.05). Spearman correlation analysis showed that cyst volume was positively correlated with Scr and gender but not iGFR (p > 0.05). The total iGFR positively correlated with eGFR (r = 0.83, p < 0.0001) and negatively with Scr (r = -0.78, p < 0.0001), age (r = -0.43, p < 0.0001), duration of T2D (r = -0.25, p = 0.001), and BMI (r = -0.21, p = 0.006) but not gender (r = -0.03, p = 0.668). The multilinear regression model revealed that gender (β = 0.346, p < 0.001), iGFR (β = -0.705, p < 0.001), and serum uric acid (β = 0.195, p = 0.032) were independent predictors of Scr. Moreover, we observed a significant increase in Scr in males (p < 0.05). Finally, we found that the split kidney function reflected by iGFR and related parameters such as time to peak (PTT) and half time of excretion (excrete t1/2) did not mutually distinguish from each other significantly whether they are measured in patients with renal cysts or in those without renal cysts (p > 0.05). CONCLUSION Our preliminary results suggest that in T2D, SRCs may be a renal complication of diabetic nephropathy. Although we found that the patients with renal cysts may display reduced iGFR, the volume of simple cysts seems not to exacerbate renal insufficiency. Isotope renography is a useful tool to evaluate the split kidney functions in diabetic patients who acquire single-side cysts.
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Affiliation(s)
- Yanyan Li
- Department of Endocrinology, Shanghai Pudong Hospital, Fudan University, Shanghai, 201399, People’s Republic of China
| | - Qingqing Lou
- Department of Nuclear Medicine, Shanghai Pudong Hospital, Fudan University, Shanghai, 201399, People’s Republic of China
| | - Song Wen
- Department of Endocrinology, Shanghai Pudong Hospital, Fudan University, Shanghai, 201399, People’s Republic of China
| | - Mingyue Zhou
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, USA
| | - Dongxiang Xu
- Department of Endocrinology, Shanghai Pudong Hospital, Fudan University, Shanghai, 201399, People’s Republic of China
| | - Chaoxun Wang
- Department of Endocrinology, Shanghai Pudong Hospital, Fudan University, Shanghai, 201399, People’s Republic of China
| | - Xingdang Liu
- Department of Nuclear Medicine, Shanghai Pudong Hospital, Fudan University, Shanghai, 201399, People’s Republic of China
| | - Ligang Zhou
- Department of Endocrinology, Shanghai Pudong Hospital, Fudan University, Shanghai, 201399, People’s Republic of China
- Shanghai Key Laboratory of Vascular Lesions Regulation and Remodeling, Shanghai, 201399, People’s Republic of China
- Correspondence: Ligang Zhou, Department of Endocrinology, Shanghai Pudong Hospital, Fudan University, Shanghai, 201399, People’s Republic of China, Tel +8613611927616, Email
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Yang S, Lai S, Wang Z, Liu A, Wang W, Guan H. Thyroid Feedback Quantile-based Index correlates strongly to renal function in euthyroid individuals. Ann Med 2021; 53:1945-1955. [PMID: 34726096 PMCID: PMC8567884 DOI: 10.1080/07853890.2021.1993324] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 10/08/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Previous studies have reported a negative relationship between thyroid-stimulating hormone (TSH) and renal function in euthyroid individuals, but others have found that higher free thyroxine (FT4) was associated with an increased risk of chronic kidney disease. This study was designed to analyze the relationship between thyroid and renal function from a new perspective of sensitivity to thyroid hormone. METHODS This retrospective study included 2831 euthyroid individuals who underwent a health examination at the First Hospital of China Medical University between January 2017 and December 2018. Parametric Thyroid Feedback Quantile-based Index (PTFQIFT4), TSH index (TSHI), thyrotroph T4 resistance index (TT4RI), free triiodothyronine to FT4 ratio (FT3/FT4), the secretory capacity of the thyroid gland (SPINA-GT) and the sum activity of peripheral deiodinases (SPINA-GD) were calculated. We also innovated the TT3RI and PTFQIFT3 indices based on FT3 and TSH. Renal function was assessed by estimated glomerular filtration rate (eGFR) CKD-EPI and creatinine-cystatin C-KDIGO equations. RESULTS After adjustment of basic characteristics and comorbidities, linear regression showed that eGFR CKD-EPI was positively associated with FT3/FT4 (β = 23.31), and inversely correlated to PTFQI FT4 (β= -2.69) (both p < .001). When comparing the fourth versus the first quartile of PTFQI FT4, the odds ratio (OR) for a reduced renal function was 1.89 (95% CI 1.28-2.80), and the OR was 0.64 (95% CI 0.43-0.95) when comparing quartiles of FT3/FT4 (both pfor trend< .05). In addition, for every 1SD increase in PTFQI FT4, the OR for a reduced renal function was 1.27 (95%CI 1.10-1.47). TSHI, TT4RI and TT3RI also showed a negative correlation to renal function. Similar results were obtained in SPINA-GD as in FT3/FT4. CONCLUSIONS In euthyroid individuals, decreased sensitivity to thyroid hormone is associated with reduced renal function. The composite PTFQIFT4 index correlates more strongly to renal function than TSH or T4 alone.KEY MESSAGESDecreased sensitivity to thyroid hormone is associated with reduced renal function in the euthyroid population.The recently developed composite index PTFQIFT4 seems to correlate more strongly to renal function than individual TSH or FT4 parameters.Innovative indices TT3RI and PTFQIFT3 based on the interaction between T3 and TSH may also reflect sensitivity to thyroid hormone.
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Affiliation(s)
- Sijue Yang
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, P.R. China†
| | - Shuiqing Lai
- Department of Endocrinology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, P.R. China
| | - Zixiao Wang
- Department of Physical Examination Center, The First Hospital of China Medical University, Shenyang, Liaoning, P.R. China
| | - Aihua Liu
- Department of Endocrinology and Metabolism, Peking University Third Hospital, Beijing, P.R. China
| | - Wei Wang
- Department of Physical Examination Center, The First Hospital of China Medical University, Shenyang, Liaoning, P.R. China
| | - Haixia Guan
- Department of Endocrinology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, P.R. China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, P.R. China
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Karzakova LM, Avtonomova OI, Kudryashov SI, Ukhterova ND, Komelyagina NА. [About connection of clinical manifestations of glomerulonephritis with features of the thyroid status of patients]. ACTA ACUST UNITED AC 2020; 66:13-23. [PMID: 33351344 DOI: 10.14341/probl11825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 04/13/2020] [Accepted: 04/26/2020] [Indexed: 11/06/2022]
Abstract
BACKGROUND There are four clinical variants of glomerulonephritis (GN) - urinary (latent), hypertensive, nephrotic and mixed. It was found that the features of clinical manifestations of GN that determine its clinical variant do not depend on the etiology, pathogenesis and morphological form of the disease. Taking into account the obtained data on the association of nephrotic syndrome with hypofunction of the thyroid gland, we suggested, that the formation of clinical variants of GN may be influenced by the features of the thyroid status of patients. AIM Study the relationship of variants of clinical manifestations of GN with indicants of thyroid status. MATERIALS AND METHODS The study included patients with primary GN who received in-treatment in the nephrology unit of a general hospital. Patients were selected into 4 groups depending on the clinical variant of GN (urinary, nephrotic, hypertensive and mixed variants). When selecting patients, we achieved comparability of groups by age, gender, morphological variants and duration of the disease. In addition to the generally accepted methods of research, patients were performed: 1) assessment of the thyroid status (thyroid-stimulating hormone (TSH), free thyroxine (free T4), free triiodothyronine (free T3), antibodies to thyroperoxidase (anti-TPO), (free T3+free T4)/TSH, free T4/free T3, free T4/TSH); 2) determination of levels of interleukin - IL-1β, IL-4 and IL-10 in blood serum; 3) ultrasound (US) examination of the thyroid gland. The obtained data were compared with those of healthy people. RESULTS The group of patients with the nephrotic variant of GN in 50% of cases showed a decrease of the level of free Т4 with the increase of TSH level, 26.7% showed a moderate increase of TSH at unchanged concentrations of free Т4 and free T3. In patients with the urinary variant of GN, the thyroid status did not differ from that in healthy patients, and the cytokine profile was characterized by a simultaneous increase in the content of the proinflammatory cytokine IL-1β and the anti-inflammatory cytokine IL-10. The group of patients with the hypertonic variant of GN in 82% of cases showed an isolated increase in TSH content. In the group of patients with a mixed variant of GN, changes in thyroid indices were predominant, combined with a large variability in the level of IL-1β production. CONCLUSIONS The results of the study indicate the influence of the functional state of the pituitary-thyroid system on the formation of different clinical variants of GN, which depends mainly on the level of production of the anti-inflammatory cytokine IL-10.
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Affiliation(s)
- Louise M Karzakova
- Federal State Budgetary Educational Institution of Higher Education "The Chuvash State University named after I.N. Ulyanov"
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10
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Zhao Y, Cai J, Zhu X, van Donkelaar A, Martin RV, Hua J, Kan H. Fine particulate matter exposure and renal function: A population-based study among pregnant women in China. ENVIRONMENT INTERNATIONAL 2020; 141:105805. [PMID: 32474297 DOI: 10.1016/j.envint.2020.105805] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 05/06/2020] [Accepted: 05/12/2020] [Indexed: 05/11/2023]
Abstract
BACKGROUND Fine particulate matter (PM2.5) is the most serious environmental threat worldwide. The nephrotoxicity of PM2.5 has been demonstrated in older adults, but no study has addressed the impacts of PM2.5 exposure on renal function in pregnant women, who are recognized to be vulnerable and susceptible to PM2.5 exposure. OBJECTIVE To evaluate whether exposures to PM2.5 total mass and its chemical constituents were associated with reduced renal function among pregnant women in China. METHODS We measured serum concentrations of urea nitrogen (UN), uric acid (UA) and creatinine for 10,052 pregnant women in Shanghai, China. Exposures to PM2.5 total mass and its 5 key chemical constituents during the whole pregnancy and each trimester of pregnancy was represented by satellite-based models. RESULTS Exposures to PM2.5 total mass and its chemical constituents of organic matter (OM), black carbon (BC), nitrate (NO3-) and ammonium (NH4+) were positively associated with serum levels of UN and UA, and negatively associated with estimated glomerular filtration rate (eGFR). An interquartile rang (IQR) increase in PM2.5 total mass, OM, BC, NO3- and NH4+ exposure in third trimester was associated with 1.33 (β = -1.33, 95% CI, -1.79, -0.87), 1.67 (β = -1.67, 95% CI, -2.26, -1.07), 1.29 (β = -1.29, 95% CI,-1.89, -0.70), 1.16 (β = -1.16, 95% CI,-1.66, -0.65) and 0.76 (β = -0.76, 95% CI, -1.08, -0.44) mL/min/1.73 m2 decrease in eGFR, respectively. CONCLUSION We concluded that exposures to PM2.5 during pregnancy were associated with decreased renal function among pregnant women.
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Affiliation(s)
- Yan Zhao
- Department of Women & Children's Health Care, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jing Cai
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Xinlei Zhu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Aaron van Donkelaar
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, N.S. Canada; Department of Energy, Environmental & Chemical Engineering, Washington University in St. Louis, St. Louis, MO, United States
| | - Randall V Martin
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, N.S. Canada; Department of Energy, Environmental & Chemical Engineering, Washington University in St. Louis, St. Louis, MO, United States
| | - Jing Hua
- Department of Women & Children's Health Care, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China.
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China.
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11
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Toda A, Hara S, Tsuji H, Arase Y. Subclinical hypothyroidism is associated with albuminuria in Japanese nondiabetic subjects. Endocrine 2020; 68:592-598. [PMID: 32060688 DOI: 10.1007/s12020-020-02220-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 01/29/2020] [Indexed: 12/14/2022]
Abstract
PURPOSE Thyroid dysfunction is a risk factor of cardiovascular disease (CVD), and albuminuria is a predictor of CVD. For preventing the CVD, it is essential to clarify from which stage of thyroid dysfunction the risk of CVD starts developing. We thus investigated the association between subclinical thyroid dysfunction and albuminuria, focusing on a nondiabetic general population. METHODS We analyzed the data of 17,221 nondiabetic subjects who underwent annual health checkups by multivariate logistic regression analyses. RESULTS Compared with the subjects with euthyroidism, those with subclinical hypothyroidism presented a higher prevalence of albuminuria. By a multivariate logistic regression analysis, subclinical hypothyroidism showed a significant and independent association with the high prevalence of albuminuria compared with euthyroidism (OR 1.64, 95% CI 1.21-2.21, p = 0.001). In accord with this result, the analysis in which the lowest quartile of thyroid stimulating hormone (TSH) concentration (<0.96 µIU/mL) was used as a reference revealed that the highest quartile (>2.07 µIU/mL) had a significant and independent association with the prevalence of albuminuria (OR 1.23, 95% CI 1.01-1.51, p = 0.04). One microliter unit per milliliter increase of the serum concentration of TSH also had a significant and independent association with the prevalence of albuminuria (OR 1.07, 95% CI 1.02-1.12, p = 0.006). The association between subclinical hyperthyroidism and the prevalence of albuminuria was not significant. CONCLUSION Our data indicated that subclinical hypothyroidism was significantly and independently associated with the high prevalence of albuminuria.
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Affiliation(s)
- Akiko Toda
- Health Management Center, Toranomon Hospital, 2-2-2, Toranomon, Minato-ku, Tokyo, 105-8470, Japan.
| | - Shigeko Hara
- Health Management Center, Toranomon Hospital, 2-2-2, Toranomon, Minato-ku, Tokyo, 105-8470, Japan
| | - Hiroshi Tsuji
- Health Management Center, Toranomon Hospital, 2-2-2, Toranomon, Minato-ku, Tokyo, 105-8470, Japan
| | - Yasuji Arase
- Health Management Center, Toranomon Hospital, 2-2-2, Toranomon, Minato-ku, Tokyo, 105-8470, Japan
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12
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Kim SH, Min HK, Lee SW. Relationship between Thyroid and Kidney Function: Analysis from the Korea National Health and Nutrition Examination Survey Between 2013 and 2015. Kidney Blood Press Res 2020; 45:442-454. [PMID: 32369813 DOI: 10.1159/000507290] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 03/16/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Thyroid function is evaluated by thyroid stimulating hormone (TSH) and free thyroxine (fT4). Although many studies have indicated an intimate relationship between thyroid hormones and kidney functions, reports about the simultaneous evaluation of TSH and fT4 are rare. OBJECTIVE We aimed to analyze the association between TSH and kidney function, with emphasis on a potential nonlinear relationship, and identify an independent relationship between fT4 and kidney function. METHODS We reviewed the data of 7,061 subjects in the Korea National Health and Nutrition Examination Surveys who were randomly subsampled for thyroid function evaluation between 2013 and 2015. A total of 5,578 subjects were included in the final analysis, after excluding people <18 years old, and those with a short fasting time, abnormal fT4 levels, and thyroid disease or related medications. Creatinine-based estimated glomerular filtration rate (eGFR) was used to define kidney function. RESULTS A 1 mmol/L increase of logarithmic TSH was associated with decreased eGFR (β: -1.8; 95% CI -2.3 to -1.2; p < 0.001), according to multivariate linear regression analysis. On the multivariate generalized additive model plot, TSH demonstrated an L-shaped relationship with eGFR, showing a steeper slope for 0-4 mIU/L of TSH. A 1 µg/dL increase of fT4 was also associated with decreased eGFR (β: -7.0; 95% CI -0.94 to -4.7; p < 0.001) on the multivariate linear regression analysis; this association was reversed after adjusting for age. On the mediation analysis, the indirect effect via age and direct effect per 1 µg/dL increase of fT4 on eGFR was 9.9 (8.1 to 11.7, p < 0.001) and -7.1 (-9.3 to -4.8, p < 0.001), respectively. CONCLUSIONS Increased TSH was associated with decreased eGFR, particularly in the reference range. The direct effect of increased fT4 was decreased eGFR, which may be affected indirectly by age.
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Affiliation(s)
- Sang Hyuk Kim
- Medical Service Corps of 2nd Armored Brigade, Republic of Korea Army, Paju, Republic of Korea
| | - Hyang Ki Min
- Department of Internal Medicine, Nowon Eulji Medical Center, Eulji University, Seoul, Republic of Korea
| | - Sung Woo Lee
- Department of Internal Medicine, Nowon Eulji Medical Center, Eulji University, Seoul, Republic of Korea,
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13
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Meuwese CL, van Diepen M, Cappola AR, Sarnak MJ, Shlipak MG, Bauer DC, Fried LP, Iacoviello M, Vaes B, Degryse J, Khaw KT, Luben RN, Åsvold BO, Bjøro T, Vatten LJ, de Craen AJM, Trompet S, Iervasi G, Molinaro S, Ceresini G, Ferrucci L, Dullaart RPF, Bakker SJL, Jukema JW, Kearney PM, Stott DJ, Peeters RP, Franco OH, Völzke H, Walsh JP, Bremner A, Sgarbi JA, Maciel RMB, Imaizumi M, Ohishi W, Dekker FW, Rodondi N, Gussekloo J, den Elzen WPJ. Low thyroid function is not associated with an accelerated deterioration in renal function. Nephrol Dial Transplant 2020; 34:650-659. [PMID: 29684213 DOI: 10.1093/ndt/gfy071] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) is frequently accompanied by thyroid hormone dysfunction. It is currently unclear whether these alterations are the cause or consequence of CKD. This study aimed at studying the effect of thyroid hormone alterations on renal function in cross-sectional and longitudinal analyses in individuals from all adult age groups. METHODS Individual participant data (IPD) from 16 independent cohorts having measured thyroid stimulating hormone, free thyroxine levels and creatinine levels were included. Thyroid hormone status was defined using clinical cut-off values. Estimated glomerular filtration rates (eGFR) were calculated by means of the four-variable Modification of Diet in Renal Disease (MDRD) formula. For this IPD meta-analysis, eGFR at baseline and eGFR change during follow-up were computed by fitting linear regression models and linear mixed models in each cohort separately. Effect estimates were pooled using random effects models. RESULTS A total of 72 856 individuals from 16 different cohorts were included. At baseline, individuals with overt hypothyroidism (n = 704) and subclinical hypothyroidism (n = 3356) had a average (95% confidence interval) -4.07 (-6.37 to -1.78) and -2.40 (-3.78 to -1.02) mL/min/1.73 m2 lower eGFR as compared with euthyroid subjects (n = 66 542). In (subclinical) hyperthyroid subjects (n = 2254), average eGFR was 3.01 (1.50-4.52) mL/min/1.73 m2 higher. During 329 713 patient years of follow-up, eGFR did not decline more rapidly in individuals with low thyroid function compared with individuals with normal thyroid function. CONCLUSIONS Low thyroid function is not associated with a deterioration of renal function. The cross-sectional association may be explained by renal dysfunction causing thyroid hormone alterations.
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Affiliation(s)
- Christiaan L Meuwese
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Merel van Diepen
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Anne R Cappola
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Mark J Sarnak
- Department of Medicine, Division of Nephrology, Tufts Medical Center, Boston, MA, USA
| | - Michael G Shlipak
- Department of Medicine, UCSF School of Medicine, San Francisco, CA, USA
| | - Douglas C Bauer
- Department of Medicine, University of California, San Francisco, CA, USA.,Department of Epidemiology and Biostatistics, University of San Francisco, CA, USA
| | - Linda P Fried
- Mailman School of Public Health and Columbia University Medical Center, New York, NY, USA
| | - Massimo Iacoviello
- University Cardiology Unit, Cardiothoracic Department, University Policlinic Hospital, Bari, Italy
| | - Bert Vaes
- Institute of Health and Society, Université catholique de Louvain (UCL), Brussels, Belgium.,Department of Public Health and Primary Care, Katholieke Universiteit Leuven (KUL), Leuven, Belgium
| | - Jean Degryse
- Institute of Health and Society, Université catholique de Louvain (UCL), Brussels, Belgium.,Department of Public Health and Primary Care, Katholieke Universiteit Leuven (KUL), Leuven, Belgium
| | - Kay-Tee Khaw
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Robert N Luben
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Bjørn O Åsvold
- Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Endocrinology, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Trine Bjøro
- Department of Medical Biochemistry, Oslo University Hospital, and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Lars J Vatten
- Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - Anton J M de Craen
- Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Stella Trompet
- Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands.,Department of Cardiology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Giorgio Iervasi
- National Council Research Institute of Clinical Physiology, Tuscany Region G. Monasterio Foundation, Pisa, Italy
| | - Sabrina Molinaro
- National Council Research Institute of Clinical Physiology, Pisa, Italy
| | - Graziano Ceresini
- Department of Clinical and Experimental Medicine, Geriatric Endocrine Unit, University Hospital of Parma, Parma, Italy
| | | | - Robin P F Dullaart
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Stephan J L Bakker
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - J Wouter Jukema
- Department of Cardiology, Leiden University Medical Centre, Leiden, The Netherlands
| | | | - David J Stott
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Robin P Peeters
- Department of Internal Medicine, Rotterdam Thyroid Center, Erasmus Medical Center, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Oscar H Franco
- Department of Internal Medicine, Rotterdam Thyroid Center, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Henry Völzke
- Institute for Community Medicine, SHIP/Clinical-Epidemiological Research & German Centre of Cardiovascular Research, University of Greifswald, Greifswald, Germany
| | - John P Walsh
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia.,Medical School, The University of Western Australia, Crawley, Western Australia
| | - Alexandra Bremner
- School of Population Health, The University of Western Australia, Crawley, Western Australia
| | - José A Sgarbi
- Division of Endocrinology, Faculdade de Medicina de Marília, Marília, Brazil
| | - Rui M B Maciel
- Division of Endocrinology, Department of Medicine, Federal University of São Paulo, São Paulo, Brazil
| | - Misa Imaizumi
- Department of Clinical Studies, Radiation Effects Research Foundation, Hiroshima and Nagasaki, Japan
| | - Waka Ohishi
- Department of Clinical Studies, Radiation Effects Research Foundation, Hiroshima and Nagasaki, Japan
| | - Friedo W Dekker
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Nicolas Rodondi
- Department of General Internal Medicine, Inselspital, University of Bern, Bern, Switzerland.,Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Jacobijn Gussekloo
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Wendy P J den Elzen
- Department of Clinical Chemistry and Laboratory Medicine, Leiden University Medical Center, Leiden, The Netherlands
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Malin AJ, Lesseur C, Busgang SA, Curtin P, Wright RO, Sanders AP. Fluoride exposure and kidney and liver function among adolescents in the United States: NHANES, 2013-2016. ENVIRONMENT INTERNATIONAL 2019; 132:105012. [PMID: 31402058 PMCID: PMC6754771 DOI: 10.1016/j.envint.2019.105012] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 07/10/2019] [Accepted: 07/11/2019] [Indexed: 05/09/2023]
Abstract
BACKGROUND Hepato- and nephrotoxicity of fluoride have been demonstrated in animals, but few studies have examined potential effects in humans. This population-based study examines the relationship between chronic low-level fluoride exposure and kidney and liver function among United States (U.S.) adolescents. This study aimed to evaluate whether greater fluoride exposure is associated with altered kidney and liver parameters among U.S. youth. METHODS This cross-sectional study utilized data from the National Health and Nutrition Examination Survey (2013-2016). We analyzed data from 1983 and 1742 adolescents who had plasma and water fluoride measures respectively and did not have kidney disease. Fluoride was measured in plasma and household tap water. Kidney parameters included estimated glomerular filtration rate (calculated by the original Schwartz formula), serum uric acid, and the urinary albumin to creatinine ratio. Liver parameters were assessed in serum and included alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, blood urea nitrogen, gamma-glutamyl transferase, and albumin. Survey-weighted linear regression examined relationships between fluoride exposure and kidney and liver parameters after covariate adjustment. A Holm-Bonferroni correction accounted for multiple comparisons. RESULTS The average age of adolescents was 15.4 years. Median water and plasma fluoride concentrations were 0.48 mg/L and 0.33 μmol/L respectively. A 1 μmol/L increase in plasma fluoride was associated with a 10.36 mL/min/1.73 m2 lower estimated glomerular filtration rate (95% CI: -17.50, -3.22; p = 0.05), a 0.29 mg/dL higher serum uric acid concentration (95% CI: 0.09, 0.50; p = 0.05), and a 1.29 mg/dL lower blood urea nitrogen concentration (95%CI: -1.87, -0.70; p < 0.001). A 1 mg/L increase in water fluoride was associated with a 0.93 mg/dL lower blood urea nitrogen concentration (95% CI: -1.44, -0.42; p = 0.007). CONCLUSIONS Fluoride exposure may contribute to complex changes in kidney and liver related parameters among U.S. adolescents. As the study is cross-sectional, reverse causality cannot be ruled out; therefore, altered kidney and/or liver function may impact bodily fluoride absorption and metabolic processes.
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Affiliation(s)
- Ashley J Malin
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Corina Lesseur
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Stefanie A Busgang
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Paul Curtin
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Robert O Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alison P Sanders
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Lin KY, Wang SY, Jiang H, Chen HC, Wu ZY, Guo YS, Zhu PL. Negative association between free triiodothyronine level and contrast-induced acute kidney injury in patients undergoing primary percutaneous coronary intervention. BMC Nephrol 2019; 20:201. [PMID: 31159763 PMCID: PMC6545736 DOI: 10.1186/s12882-019-1386-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 05/15/2019] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND A low FT3 level is significantly associated with a variety of kidney disease and acute myocardial infarction (AMI). However, it remains unclear whether low FT3 is associated with CI-AKI in patients who underwent pPCI. METHODS Single-center retrospective study evaluated 363 STEMI patients undergoing pPCI. Patients were classfied into 2 groups, low FT3 group (FT3 < 3.1 pmol/L) and normal FT3 group (FT3 ≥ 3.1 pmol/L);CI-AKI was defined as an increase in the serum creatinine levels of ≥50% or 0.3 mg/dL above the baseline level within 48 h after contrast medium exposure. RESULTS Overall, 80(22.0%) patients had low FT3, and 59(16.3%) patients developed CI-AKI. The incidence of CI-AKI and in-hospital mortality was significantly higher in patients with low FT3 than normal (31.3% vs 12.0%; 15.0% vs 3.2%, respectively, both p < 0.0001). Multivariate logistic regression analysis indicated that low FT3 was an independent predictor of CI-AKI (odds ratio [OR] = 2.62, 95%CI:1.35-5.07, p < 0.05). In addition, low FT3 was associated with an increased risk of all-cause mortality during a mean follow-up period of 20 months (hazard ratio [HR] = 2.54, 95%CI:1.15-5.60, p < 0.05). CONCLUSION Low FT3 was associated with CI-AKI, short- and long-term mortality in STEMI patients after pPCI.
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Affiliation(s)
- Kai-Yang Lin
- Department of Cardiology, Fujian Provincial Hospital, Fujian Medical University, Fujian Cardiovascular Institute, Fujian Provincial Center for Geriatrics, Fuzhou, 350001, China
| | - Sun-Ying Wang
- Department of Cardiology, Fujian Provincial Hospital, Fujian Medical University, Fujian Cardiovascular Institute, Fujian Provincial Center for Geriatrics, Fuzhou, 350001, China
| | - Hui Jiang
- Department of Cardiology, Fujian Provincial Hospital, Fujian Medical University, Fujian Cardiovascular Institute, Fujian Provincial Center for Geriatrics, Fuzhou, 350001, China
| | - Han-Chuan Chen
- Department of Cardiology, Fujian Provincial Hospital, Fujian Medical University, Fujian Cardiovascular Institute, Fujian Provincial Center for Geriatrics, Fuzhou, 350001, China
| | - Zhi-Yong Wu
- Department of Cardiology, Fujian Provincial Hospital, Fujian Medical University, Fujian Cardiovascular Institute, Fujian Provincial Center for Geriatrics, Fuzhou, 350001, China
| | - Yan-Song Guo
- Department of Cardiology, Fujian Provincial Hospital, Fujian Medical University, Fujian Cardiovascular Institute, Fujian Provincial Center for Geriatrics, Fuzhou, 350001, China.
| | - Peng-Li Zhu
- Department of Cardiology, Fujian Provincial Hospital, Fujian Medical University, Fujian Cardiovascular Institute, Fujian Provincial Center for Geriatrics, Fuzhou, 350001, China.
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