Low glomerular filtration rate values are associated with higher TSH in an elderly population at high cardiovascular disease risk.

Background: </strong>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 el...

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Autores: Brenta, Gabriela, Nepote, Alejandra, Barreto, Adriana, Musso, Carla, Faingold, Cristina, Fossati, Pia, Antonelli, Alessandro, Fallahi, Poupak, Famá, Fausto, Meroño, Tomás
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2023
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/227644
Acceso en línea:https://hdl.handle.net/2445/227644
Access Level:acceso abierto
Palabra clave:Persones grans
Malalties cardiovasculars
Malalties de la tiroide
Hipotiroïdisme
Older people
Cardiovascular diseases
Thyroid diseases
Hypothyroidism
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repository_id_str
spelling Low glomerular filtration rate values are associated with higher TSH in an elderly population at high cardiovascular disease risk.Brenta, GabrielaNepote, AlejandraBarreto, AdrianaMusso, CarlaFaingold, CristinaFossati, PiaAntonelli, AlessandroFallahi, PoupakFamá, FaustoMeroño, TomásPersones gransMalalties cardiovascularsMalalties de la tiroideHipotiroïdismeOlder peopleCardiovascular diseasesThyroid diseasesHypothyroidismBackground: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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 <em>vs.</em> 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<sup>2</sup> = 0.25) was found an independent predictor of GFR.</p><p><strong>Conclusion: </strong>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 Media2023info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/2445/227644Articles publicats en revistes (Nutrició, Ciències de l'Alimentació i Gastronomia)reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésReproducció del document publicat a: https://doi.org/10.3389/fendo.2023.1162626Frontiers In Endocrinology, 2023https://doi.org/10.3389/fendo.2023.1162626cc-by (c) Brenta G et al., 2023http://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/2276442026-05-27T06:46:51Z
dc.title.none.fl_str_mv 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.
spellingShingle Low glomerular filtration rate values are associated with higher TSH in an elderly population at high cardiovascular disease risk.
Brenta, Gabriela
Persones grans
Malalties cardiovasculars
Malalties de la tiroide
Hipotiroïdisme
Older people
Cardiovascular diseases
Thyroid diseases
Hypothyroidism
title_short 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_sort Low glomerular filtration rate values are associated with higher TSH in an elderly population at high cardiovascular disease risk.
dc.creator.none.fl_str_mv Brenta, Gabriela
Nepote, Alejandra
Barreto, Adriana
Musso, Carla
Faingold, Cristina
Fossati, Pia
Antonelli, Alessandro
Fallahi, Poupak
Famá, Fausto
Meroño, Tomás
author Brenta, Gabriela
author_facet Brenta, Gabriela
Nepote, Alejandra
Barreto, Adriana
Musso, Carla
Faingold, Cristina
Fossati, Pia
Antonelli, Alessandro
Fallahi, Poupak
Famá, Fausto
Meroño, Tomás
author_role author
author2 Nepote, Alejandra
Barreto, Adriana
Musso, Carla
Faingold, Cristina
Fossati, Pia
Antonelli, Alessandro
Fallahi, Poupak
Famá, Fausto
Meroño, Tomás
author2_role author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Persones grans
Malalties cardiovasculars
Malalties de la tiroide
Hipotiroïdisme
Older people
Cardiovascular diseases
Thyroid diseases
Hypothyroidism
topic Persones grans
Malalties cardiovasculars
Malalties de la tiroide
Hipotiroïdisme
Older people
Cardiovascular diseases
Thyroid diseases
Hypothyroidism
description Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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 <em>vs.</em> 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<sup>2</sup> = 0.25) was found an independent predictor of GFR.</p><p><strong>Conclusion: </strong>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.
publishDate 2023
dc.date.none.fl_str_mv 2023
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/227644
url https://hdl.handle.net/2445/227644
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.3389/fendo.2023.1162626
Frontiers In Endocrinology, 2023
https://doi.org/10.3389/fendo.2023.1162626
dc.rights.none.fl_str_mv cc-by (c) Brenta G et al., 2023
http://creativecommons.org/licenses/by/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc-by (c) Brenta G et al., 2023
http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Frontiers Media
publisher.none.fl_str_mv Frontiers Media
dc.source.none.fl_str_mv Articles publicats en revistes (Nutrició, Ciències de l'Alimentació i Gastronomia)
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.812455

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