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. 2023 Sep 4;12(17):5763.
doi: 10.3390/jcm12175763.

High Thyroid-Stimulating Hormone and Low Free Triiodothyronine Levels Are Associated with Chronic Kidney Disease in Three Population-Based Studies from Germany

Till Ittermann  1 , Sabrina von Rheinbaben  2 , Marcello R P Markus  3 , Marcus Dörr  3   4 , Antje Steveling  2 , Matthias Nauck  4   5 , Alexander Teumer  4   6 , Maik Gollasch  7 , Dominik Spira  8 , Maximilian König  7 , Ilja Demuth  8   9 , Elisabeth Steinhagen-Thiessen  8 , Henry Völzke  1 , Sylvia Stracke  2
Affiliations

High Thyroid-Stimulating Hormone and Low Free Triiodothyronine Levels Are Associated with Chronic Kidney Disease in Three Population-Based Studies from Germany

Till Ittermann et al. J Clin Med. .

Abstract

High serum thyroid-stimulating hormone (TSH) levels have previously been associated with a low estimated glomerular filtration rate (eGFR), but studies associating thyroid hormone levels with albuminuria revealed inconsistent results. We used cross-sectional data from 7933 individuals aged 20 to 93 years of the Berlin Aging Study II and the Study of Health in Pomerania to associate serum TSH, fT3, and fT4 levels with eGFR and albuminuria. In multivariable analyses adjusted for confounding, we found inverse non-linear associations of serum TSH levels with eGFR, while serum fT3 levels showed a positive association with eGFR. High as well as low serum fT4 levels were associated with a lower eGFR. Age but not sex modified the association between thyroid hormone levels and eGFR. The inverse associations between serum TSH levels and eGFR were strongest in the youngest age groups, while the positive associations between serum fT3 levels and eGFR were strongest in older individuals. No significant associations between thyroid hormone levels and albuminuria were found. Our results indicate that hypothyroidism might be associated with a reduced kidney function. Thyroid function might be more tightly related to the eGFR than to albuminuria in the general population.

Keywords: albuminuria; chronic kidney disease; estimated glomerular filtration rate; thyroid hormones; thyroid-stimulating hormone.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of the study population.
Figure 2
Figure 2
Directed acyclic graph to determine the confounding variables for the association of thyroid function with kidney function. Confounding variables are marked in red.
Figure 3
Figure 3
Associations between serum TSH levels and kidney function adjusted for confounding. Results are reported as adjusted regression curves (solid line) and 95% confidence interval.
Figure 4
Figure 4
Associations between serum fT3 levels and kidney function adjusted for confounding. Results are reported as adjusted regression curves (solid line) and 95% confidence interval.
Figure 5
Figure 5
Associations between serum fT4 levels and kidney function adjusted for confounding. Results are reported as adjusted regression curves (solid line) and 95% confidence interval.
Figure 6
Figure 6
Effect modification by age on the associations between thyroid hormone levels and eGFR calculated using FAS adjusted for confounding.
See this image and copyright information in PMC

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