Abstract
Subclinical hypothyroidism has been associated with dyslipidemia, hypertension, and increased risk of coronary artery disease. However, limited is known for its effect on renal function. Here we aimed to investigate whether subclinical hypothyroidism is associated with reduced estimated glomerular filtration rate (eGFR) and proteinuria in the general population. A cross-sectional cohort of 74,356 adults aged ≥20 year participating in voluntary health examinations without previous thyroid diseases were recruited in Taiwan. The mean eGFR of persons with euthyroidism, subclinical, and overt hypothyroidism are 87.99, 83.46, and 72.22 mL/min/1.73 m2, respectively (P-for- trend < 0.001). The proportion of proteinuria in persons with euthyroidism, subclinical and overt hypothyroidism is 1.29%, 2.2%, and 2.97%, respectively (P-for-trend: 0.001). The odds ratio of CKD for subclinical, clinical, and all hypothyroidism is 2.04 (95% confidence interval (CI): 1.67-2.50) and 7.61 (95% CI: 4.92-11.77), and 2.41 (95% CI: 2.01–2.89), respectively as compared to euthyroidism. These odd ratios remained significant after further adjustments. The odds ratios for proteinuria is 2.04 (95% CI: 1.67–2.50), 7.61 (95% CI: 4.92–11.77), and 2.41 (95% CI: 2.01–2.89) for subclinical, clinical, and total hypothyroidism, respectively, although the odds ratios were attenuated after further adjustment. Our results suggest subclinical hypothyroidism is a novel risk factor of reduced renal function but not proteinuria.
Highlights
The concept of mild or subclinical hypothyroidism has emerged in recent decades with the advent of advanced technique to detect subtle changes in thyroid function
Hypothyroidism has been shown to cause edema in humans owing to increased capillary permeability to protein, which is reversed by thyroid hormone treatment[18]
Hypothyroid participants without dysglycemia had a slightly higher OR of decreased estimated glomerular filtration rate (eGFR) than those with dysglycemia (Supplementary Table 4). In this large cross-sectional study involving 74,356 participants recruited from a voluntary health examination program, we found a clear dose-dependent association between hypothyroid status and eGFR and proteinuria
Summary
The concept of mild or subclinical hypothyroidism has emerged in recent decades with the advent of advanced technique to detect subtle changes in thyroid function. Several studies showed that subclinical hypothyroidism is associated with dyslipidemia, hypertension, accelerated atherosclerosis, and coronary artery disease[5,6,7]. Hypothyroidism has been shown to cause edema in humans owing to increased capillary permeability to protein, which is reversed by thyroid hormone treatment[18]. These data suggest that hypothyroidism may reduce glomerular infiltration rate and promote urine protein loss. There are, a limited number of studies investigating the impact of subclinical or clinical hypothyroidism on estimated glomerular filtration rate (eGFR) and proteinuria in the general population. We investigate the association of subclinical and clinical hypothyroidism with eGFR and proteinuria in a large Taiwanese cohort
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