Abnormal Thyroid-Stimulating Hormone and Chronic Kidney Disease in Elderly Adults in Taipei City

• Autores: Mei-hsing Chuang, Kuo-Meng Liao
• Localización: Journal of the American Geriatrics Society, ISSN 0002-8614, Vol. 64, Nº. 6, 2016, págs. 1267-1273
• Idioma: inglés
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• Resumen

  • Objectives To examine whether older people with abnormal thyroid function are more likely to develop chronic kidney disease (CKD) over a 5-year follow-up period.

    Design Retrospective cohort study.

    Setting Health examination data from the Taipei Databank for Public Health Analysis.

    Participants Individuals aged 65 and older (N = 41,454).

    Measurements Thyroid-stimulating hormone (TSH) levels were repeatedly measured, and subjects were categorized into four thyroid function groups (hyperthyroid, euthyroid, subclinical hypothyroid, overt hypothyroid). The risk of incident CKD was evaluated using a stepwise Cox proportional hazards regression model adjusted for sex, baseline age, hypertension, diabetes mellitus (DM), dyslipidemia, hyperuricemia, anemia, obesity, liver function, smoking, and alcohol.

    Results Higher TSH levels were associated with greater risk of subsequent CKD. Individuals with subclinical hypothyroidism (hazard ratio (HR) = 1.15, 95% confidence interval (CI) = 1.05–1.26) and those with overt hypothyroidism (HR = 1.27, 95% CI = 1.04–1.55) were more likely than those who were euthyroid to have CKD. Women were more likely to have CKD than men (HR = 1.11, 95% CI = 1.06–1.16). When stratified by gender, subclinical hypothyroidism in women was associated with an increased risk of developing CKD (HR = 1.22; 95% CI = 1.08–1.39). When stratified by DM, subclinical hypothyroidism and overt hypothyroidism were associated with an increased risk of developing CKD in nondiabetics (HR = 1.19; 95% CI = 1.07–1.31; and HR = 1.34; 95% CI = 1.08–1.65, respectively).

    Conclusion This cohort study of elderly persons in Taipei City found a significant association between hypothyroidism and development of CKD in women and individuals without DM.