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Serum Thyrotropin Elevation and Coronary Artery Calcification in Hemodialysis Patients

Connie M Rhee1, Matthew Budoff2, Gregory Brent3,4

  • 1Harold Simmons Center for Chronic Disease Research and Epidemiology, University of California Irvine School of Medicine, Orange, California, USA.

Cardiorenal Medicine
|May 13, 2022
PubMed

Insights

Higher serum thyrotropin (TSH) levels are linked to increased coronary artery calcification (CAC) in hemodialysis patients. This finding suggests a potential role for thyroid function in cardiovascular risk for this population.

Area of Science:

  • Nephrology
  • Endocrinology
  • Cardiology

Background:

  • Hypothyroidism is common in end-stage kidney disease (ESKD) patients.
  • Lower thyroid hormone levels may increase coronary artery calcification (CAC) risk in ESKD.
  • The association between serum thyrotropin (TSH) and CAC in hemodialysis patients remains unexamined.

Purpose of the Study:

  • To investigate the relationship between serum TSH levels and CAC risk in hemodialysis patients.
  • To assess if TSH is an independent predictor of CAC in this population.

Main Methods:

  • Secondary analysis of data from the Anti-Inflammatory and Anti-Oxidative Nutrition in Hypoalbuminemic Dialysis Patients trial.
  • Serum TSH levels and CAC were assessed using cardiac computed tomography scans.
  • Multivariable logistic regression was used to evaluate the association between TSH and CAC Volume (VS) and Agatston score (AS).

Main Results:

  • Higher TSH levels (highest tertile) were associated with significantly elevated CAC VS and AS (adjusted ORs 4.26 and 5.53, respectively).
  • TSH levels >3.0 mIU/L were also linked to increased CAC VS and AS.
  • Lower direct free thyroxine levels showed a trend towards elevated CAC, but did not reach statistical significance.

Conclusions:

  • Elevated serum TSH is associated with increased CAC burden in hemodialysis patients.
  • Further research is warranted to explore thyroid hormone supplementation as a strategy to reduce CAC in this high-risk group.
Abstract

Keywords:
CalcificationDialysisEnd-stage kidney diseaseThyroidThyrotropin

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