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. 2024 Feb 7;14(2):111.
doi: 10.3390/metabo14020111.

Relationship of Thyroid Function with Renal Hemodynamics and Cholesterol Metabolism in Proteinuric Kidney Disease: A Pilot Study

Yoshitaka Iwazu  1   2   3 , Kazuhiko Kotani  1   4 , Taro Sugase  5 , Daisuke Nagata  3 , Toshiyuki Yamada  1
Affiliations

Relationship of Thyroid Function with Renal Hemodynamics and Cholesterol Metabolism in Proteinuric Kidney Disease: A Pilot Study

Yoshitaka Iwazu et al. Metabolites. .

Abstract

Nephrotic syndrome and hypothyroidism are respectively reported to influence renal hemodynamics and hypercholesterolemia. However, the relationship of proteinuria-associated thyroid function with renal hemodynamics and cholesterol metabolism has yet to be determined in a simultaneous analysis of thyroid, renal, and cholesterol variables. We investigated the hypothesis that the changes in thyroid hormones by proteinuria may contribute to changes in cholesterol metabolism and renal hemodynamics by proteinuria. Twenty-nine patients (17 men and 12 women) with proteinuric kidney disease (mean age 46 years) were enrolled in a pilot study. Data for serum free triiodothyronine (FT3), free thyroxine (FT4), total cholesterol, and filtration fraction (FF; assessed by para-aminohippuric acid clearance) were used in variable-adjusted correlation analyses. The patients had the following data (mean ± standard deviation): urinary protein 5.18 ± 3.28 g/day, FT3 2.18 ± 0.44 pg/mL, FT4 1.03 ± 0.26 ng/dL, FF 0.27 ± 0.07, and total cholesterol 327 ± 127 mg/dL. There was a significant positive correlation of FT3 with FF (β = 0.58, p = 0.01) and a significant inverse correlation of FT4 with total cholesterol (β = -0.40, p = 0.01). A positive correlation of FT3 with FF and an inverse correlation of FT4 with total cholesterol were demonstrated in patients with proteinuric kidney disease. The proteinuria-associated reduction in serum thyroid hormone levels was correlated with hypercholesterolemia and the reduced glomerular FF. Further studies of these relationships are required.

Keywords: filtration fraction; free thyroxine; free triiodothyronine; hypercholesterolemia; nephrotic syndrome; para-aminohippurate.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Correlations of serum free triiodothyronine (FT3) (A) and thyroxine (FT4) (B) concentrations with urinary protein excretion in the study population. The r value represents the nonparametric Spearman correlation coefficient.
Figure 2
Figure 2
Correlations of serum free triiodothyronine (FT3) (A) and thyroxine (FT4) (B) concentrations with urinary protein excretion, selectivity index, and serum albumin levels in the UPE > 3.5 g/day group. The r value represents the nonparametric Spearman correlation coefficient.
Figure 3
Figure 3
Correlations of serum free triiodothyronine (FT3) (A) and thyroxine (FT4) (B) concentrations with filtration fraction levels in the patients without renin–angiotensin–aldosterone system inhibitors. Correlations of thyroid function (C,D) with serum cholesterol levels in the patients without lipid-lowering agents with prednisolone. The r value represents the nonparametric Spearman correlation coefficient.
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