The Changes Of Thyroid Hormone Level In Patients With End Stage Kidney Disease And Its Relationship With Atherosclerosis

Objective: To observe the changes of thyroid hormone level in patients with endstage renal disease, and to explore the relationship with atherosclerosis.Methods: We collected96patients who were hospitalized in the Second AffiliatedHospital of Dalian Medical University from April2012to January2013. The inclusioncriteria:1. All patients were diagnosed with end stage renal disease;2. Diseases whichaffect the thyroid hormone level were passed, such as recent infection, acute myocardialinfarction, heart failure, acute cerebrovascular, brain trauma, tumor, diabetic withketoacidosis, surgery;3. All patients had no history of thyroid disease and drugs whichaffect thyroid function were not taken. Detection indicators include:1. The human bodymeasure: body weight, height, blood pressure, body mass index (BMI), pulse pressuredifference;2. Serological indicators: hemoglobin (Hb), mean platelet volume (MPV),fibrinogen (Fbg), cholesterol (TC), triglyceride (TG), high density lipoproteincholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), serum albumin(Alb), serum prealbumin (PA), fasting blood glucose;3. Thyroid hormone: Theradioimmunoassay (RIA) was used to detect three free triiodothyronine (FT3), freethyroxine (FT4), thyroid-stimulating hormone (s-TSH);4. The inflammation index:Lmmunoturbidimetry was used to analyze c-reactive protein(CRP);5. Imagingexamination: The American GE-LOGIQ-7ultrasonic diagnostic apparatus was used forcarotid intima-media thickness (CIMT) measurement. According to the thyroidhormone level, patients were divided into the low T3syndrome group and normalthyroid hormone group.Then we made statistics and analysis about the data of twogroups.Results: In96patients with end stage renal disease, the mean age was50.2±11.56,including42male and54female.96patients with end stage renal disease included56cases of non-dialysis patients and40hemodialysis patients.35patients’ FT3level wasdecreased (36.46%) and34patients’ thyroid hormone were normal (35.43%) and others were27cases（28.11%）which meant that the low T3syndrome was the maincharacteristic of the patients with end stage renal disease. There was no statisticalsignificance between low T3syndrome group and normal thyroid hormone group inpatients’ age, sex, BMI, blood pressure, blood glucose and the number of dialysispatients (P>0.05). The levels of TC, TG and LDL-C were higher in Low T3syndromegroup than in normal thyroid hormone group (P<0.05)，but the level of HDL-C waslower (P <0.05). The levels of Fbg, MPV and CRP were higher in lower T3syndromegroup than in normal thyroid hormone group (P<0.01, P<0.05, P<0.01). The correlationanalysis showed that the levels of serous FT3was negatively correlated with TC, TG,LDL-C, Fbg, MVP, CRP (P<0.05) and significantly positively correlated withHDL-C(P<0.01) in patients with end stage kidney disease. In addition, the level ofCIMT was higher in lower T3syndrome group than in normal thyroid hormone group(P<0.05) and the correlation analysis showed that the level of serous FT3wasnegatively correlated with CIMT (r=-0.40, P<0.05). Lastly, the levels of Hb, ALB andPA in low T3syndrome group and normal thyroid hormone group had no statisticallysignificant difference (P>0.05).Conclusions:1.Patients with end stage renal disease often were accompanied with the changes ofthyroid hormone level and the low T3syndrome was the most common.2.The low T3syndrome was closely associated with the patients’ carotid arteryintima-media thickness. It also was the independent risk factor for atherosclerosis. Itcould increase the risk of atherosclerosis in patients by aggravating lipid disorders andinflammation and increasing fibrinogen and mean platelet volume.