Thyroid hormone levels and incident chronic kidney disease in euthyroid individuals: The Kangbuk Samsung Health Study

Yiyi Zhang, Yoosoo Chang, Seungho Ryu, Juhee Cho, Won Young Lee, Eun Jung Rhee, Min Jung Kwon, Roberto Pastor-Barriuso, Sanjay Rampal, Won Kon Han, Hocheol Shin, Eliseo Guallar

Research output: Contribution to journalArticle

Abstract

Background: Overt and subclinical hypothyroidism are associated with higher levels of serum creatinine and with increased risk of chronic kidney disease (CKD). The prospective association between thyroid hormones and kidney function in euthyroid individuals, however, is largely unexplored. Methods: We conducted a prospective cohort study in 104 633 South Korean men and women who were free of CKD and proteinuria at baseline and had normal thyroid hormone levels and no history of thyroid disease or cancer. At each annual or biennial follow-up visit, thyroid-stimulating hormone (TSH), free triiodothyronine (FT3) and free thyroxin (FT4) levels were measured by radioimmunoassay. The study outcome was incident CKD, defined as an estimated glomerular filtration rate (eGFR) 2 based on the Chronic Kidney Disease Epidemiology Collaboration creatinine equation. Results: After a median follow-up of 3.5 years, 1032 participants developed incident CKD. There was a positive association between high-normal levels of TSH and increased risk of incident CKD. In fully-adjusted models including baseline eGFR, the hazard ratio comparing the highest vs the lowest quintiles of TSH was 1.26 [95% confidence interval (CI) 1.02 to 1.55; P for linear trend=0.03]. In spline models, FT3 levels below 3 pg/ml were also associated with increased risk of incident CKD. There was no association between FT4 levels and CKD. Conclusions: In a large cohort of euthyroid men and women, high levels of TSH and low levels of FT3, even within the normal range, were modestly associated with an increased risk of incident CKD.

Original languageEnglish (US)
Article numberdyu126
Pages (from-to)1624-1632
Number of pages9
JournalInternational Journal of Epidemiology
Volume43
Issue number5
DOIs
StatePublished - Aug 20 2014

Fingerprint

Thyroid Hormones
Chronic Renal Insufficiency
Health
Thyrotropin
Glomerular Filtration Rate
Creatinine
Thyroid Diseases
Triiodothyronine
Hypothyroidism
Thyroxine
Proteinuria
Thyroid Neoplasms
Radioimmunoassay
Reference Values
Epidemiology
Cohort Studies
Outcome Assessment (Health Care)
Prospective Studies
Confidence Intervals
Kidney

Keywords

  • Kidney disease
  • Thyroid hormones
  • Thyrotropin
  • Thyroxin
  • Triiodothyronine

ASJC Scopus subject areas

  • Epidemiology
  • Medicine(all)

Cite this

Thyroid hormone levels and incident chronic kidney disease in euthyroid individuals : The Kangbuk Samsung Health Study. / Zhang, Yiyi; Chang, Yoosoo; Ryu, Seungho; Cho, Juhee; Lee, Won Young; Rhee, Eun Jung; Kwon, Min Jung; Pastor-Barriuso, Roberto; Rampal, Sanjay; Han, Won Kon; Shin, Hocheol; Guallar, Eliseo.

In: International Journal of Epidemiology, Vol. 43, No. 5, dyu126, 20.08.2014, p. 1624-1632.

Research output: Contribution to journalArticle

Zhang, Y, Chang, Y, Ryu, S, Cho, J, Lee, WY, Rhee, EJ, Kwon, MJ, Pastor-Barriuso, R, Rampal, S, Han, WK, Shin, H & Guallar, E 2014, 'Thyroid hormone levels and incident chronic kidney disease in euthyroid individuals: The Kangbuk Samsung Health Study', International Journal of Epidemiology, vol. 43, no. 5, dyu126, pp. 1624-1632. https://doi.org/10.1093/ije/dyu126
Zhang, Yiyi ; Chang, Yoosoo ; Ryu, Seungho ; Cho, Juhee ; Lee, Won Young ; Rhee, Eun Jung ; Kwon, Min Jung ; Pastor-Barriuso, Roberto ; Rampal, Sanjay ; Han, Won Kon ; Shin, Hocheol ; Guallar, Eliseo. / Thyroid hormone levels and incident chronic kidney disease in euthyroid individuals : The Kangbuk Samsung Health Study. In: International Journal of Epidemiology. 2014 ; Vol. 43, No. 5. pp. 1624-1632.
@article{e89eec54c54d4902b4bd88b1d74e634b,
title = "Thyroid hormone levels and incident chronic kidney disease in euthyroid individuals: The Kangbuk Samsung Health Study",
abstract = "Background: Overt and subclinical hypothyroidism are associated with higher levels of serum creatinine and with increased risk of chronic kidney disease (CKD). The prospective association between thyroid hormones and kidney function in euthyroid individuals, however, is largely unexplored. Methods: We conducted a prospective cohort study in 104 633 South Korean men and women who were free of CKD and proteinuria at baseline and had normal thyroid hormone levels and no history of thyroid disease or cancer. At each annual or biennial follow-up visit, thyroid-stimulating hormone (TSH), free triiodothyronine (FT3) and free thyroxin (FT4) levels were measured by radioimmunoassay. The study outcome was incident CKD, defined as an estimated glomerular filtration rate (eGFR) 2 based on the Chronic Kidney Disease Epidemiology Collaboration creatinine equation. Results: After a median follow-up of 3.5 years, 1032 participants developed incident CKD. There was a positive association between high-normal levels of TSH and increased risk of incident CKD. In fully-adjusted models including baseline eGFR, the hazard ratio comparing the highest vs the lowest quintiles of TSH was 1.26 [95{\%} confidence interval (CI) 1.02 to 1.55; P for linear trend=0.03]. In spline models, FT3 levels below 3 pg/ml were also associated with increased risk of incident CKD. There was no association between FT4 levels and CKD. Conclusions: In a large cohort of euthyroid men and women, high levels of TSH and low levels of FT3, even within the normal range, were modestly associated with an increased risk of incident CKD.",
keywords = "Kidney disease, Thyroid hormones, Thyrotropin, Thyroxin, Triiodothyronine",
author = "Yiyi Zhang and Yoosoo Chang and Seungho Ryu and Juhee Cho and Lee, {Won Young} and Rhee, {Eun Jung} and Kwon, {Min Jung} and Roberto Pastor-Barriuso and Sanjay Rampal and Han, {Won Kon} and Hocheol Shin and Eliseo Guallar",
year = "2014",
month = "8",
day = "20",
doi = "10.1093/ije/dyu126",
language = "English (US)",
volume = "43",
pages = "1624--1632",
journal = "International Journal of Epidemiology",
issn = "0300-5771",
publisher = "Oxford University Press",
number = "5",

}

TY - JOUR

T1 - Thyroid hormone levels and incident chronic kidney disease in euthyroid individuals

T2 - The Kangbuk Samsung Health Study

AU - Zhang, Yiyi

AU - Chang, Yoosoo

AU - Ryu, Seungho

AU - Cho, Juhee

AU - Lee, Won Young

AU - Rhee, Eun Jung

AU - Kwon, Min Jung

AU - Pastor-Barriuso, Roberto

AU - Rampal, Sanjay

AU - Han, Won Kon

AU - Shin, Hocheol

AU - Guallar, Eliseo

PY - 2014/8/20

Y1 - 2014/8/20

N2 - Background: Overt and subclinical hypothyroidism are associated with higher levels of serum creatinine and with increased risk of chronic kidney disease (CKD). The prospective association between thyroid hormones and kidney function in euthyroid individuals, however, is largely unexplored. Methods: We conducted a prospective cohort study in 104 633 South Korean men and women who were free of CKD and proteinuria at baseline and had normal thyroid hormone levels and no history of thyroid disease or cancer. At each annual or biennial follow-up visit, thyroid-stimulating hormone (TSH), free triiodothyronine (FT3) and free thyroxin (FT4) levels were measured by radioimmunoassay. The study outcome was incident CKD, defined as an estimated glomerular filtration rate (eGFR) 2 based on the Chronic Kidney Disease Epidemiology Collaboration creatinine equation. Results: After a median follow-up of 3.5 years, 1032 participants developed incident CKD. There was a positive association between high-normal levels of TSH and increased risk of incident CKD. In fully-adjusted models including baseline eGFR, the hazard ratio comparing the highest vs the lowest quintiles of TSH was 1.26 [95% confidence interval (CI) 1.02 to 1.55; P for linear trend=0.03]. In spline models, FT3 levels below 3 pg/ml were also associated with increased risk of incident CKD. There was no association between FT4 levels and CKD. Conclusions: In a large cohort of euthyroid men and women, high levels of TSH and low levels of FT3, even within the normal range, were modestly associated with an increased risk of incident CKD.

AB - Background: Overt and subclinical hypothyroidism are associated with higher levels of serum creatinine and with increased risk of chronic kidney disease (CKD). The prospective association between thyroid hormones and kidney function in euthyroid individuals, however, is largely unexplored. Methods: We conducted a prospective cohort study in 104 633 South Korean men and women who were free of CKD and proteinuria at baseline and had normal thyroid hormone levels and no history of thyroid disease or cancer. At each annual or biennial follow-up visit, thyroid-stimulating hormone (TSH), free triiodothyronine (FT3) and free thyroxin (FT4) levels were measured by radioimmunoassay. The study outcome was incident CKD, defined as an estimated glomerular filtration rate (eGFR) 2 based on the Chronic Kidney Disease Epidemiology Collaboration creatinine equation. Results: After a median follow-up of 3.5 years, 1032 participants developed incident CKD. There was a positive association between high-normal levels of TSH and increased risk of incident CKD. In fully-adjusted models including baseline eGFR, the hazard ratio comparing the highest vs the lowest quintiles of TSH was 1.26 [95% confidence interval (CI) 1.02 to 1.55; P for linear trend=0.03]. In spline models, FT3 levels below 3 pg/ml were also associated with increased risk of incident CKD. There was no association between FT4 levels and CKD. Conclusions: In a large cohort of euthyroid men and women, high levels of TSH and low levels of FT3, even within the normal range, were modestly associated with an increased risk of incident CKD.

KW - Kidney disease

KW - Thyroid hormones

KW - Thyrotropin

KW - Thyroxin

KW - Triiodothyronine

UR - http://www.scopus.com/inward/record.url?scp=84913594920&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84913594920&partnerID=8YFLogxK

U2 - 10.1093/ije/dyu126

DO - 10.1093/ije/dyu126

M3 - Article

C2 - 25011453

AN - SCOPUS:84913594920

VL - 43

SP - 1624

EP - 1632

JO - International Journal of Epidemiology

JF - International Journal of Epidemiology

SN - 0300-5771

IS - 5

M1 - dyu126

ER -