Journal of Endocrinology and Metabolism, ISSN 1923-2861 print, 1923-287X online, Open Access
Article copyright, the authors; Journal compilation copyright, J Endocrinol Metab and Elmer Press Inc
Journal website https://www.jofem.org

Original Article

Volume 12, Number 3, June 2022, pages 89-96


Thyroid-Stimulating Hormone and Estimated Glomerular Filtration Rate

Tables

Table 1. Baseline Characteristics
 
DemographicsNumber of subjectsMedian/proportionIQR/ratio
BMI: body mass index; GERD: gastroesophageal reflux disease; COPD: chronic obstructive pulmonary disease; HbA1c: hemoglobin A1c; eGFR: estimated glomerular filtration rate; HDL: high-density lipoprotein; LDL: low-density lipoprotein; IQR: interquartile range.
Age (years)3127329 - 99
Gender: male58.33%124/212
Height (m)2971.680.91 - 1.7
Weight (kg)29978.434 - 150
BMI (kg/m2)29427.816.8 - 48.8
Race312
  Caucasian18459%
  Arab3611.5%
  Asian5116.4%
  Black206.4%
  Europe165.1%
  South American51.6%
Comorbidities
  Diabetes mellitus31243.3%92
  Dementia3122.2%5
  Pacemaker3126.1%13
  Gout31214.4%31
  GERD3129.9%21
  Atrial fibrillation31212.5%27
  Peripheral vascular disease31211.5%24
  Cerebrovascular disease3129.9%21
  Coronary artery disease31226%55
  Congestive heart failure31213.5%42
  Cancer31231%66
  Liver disease3122.2%7
  COPD31216.7%35
  Deep venous thrombosis3124.2%9
  Dyslipidemia31243.2%92
  Hematuria31230.7%65
  Proteinuria31243.2%134
  Hypothyroidism31212.8%40
Clinic variable
  Systolic blood pressure (mm Hg)30614188 - 239
  Diastolic blood pressure (mm Hg)3067540 - 104
  Heart rate (beats per minute)3077132 - 140
Medication
  Levothyroxine (µg)39880-225
Laboratory
  Thyroid-stimulating hormone (µIU/L)2111.850.06 - 109.5
  Baseline eGFR (mL/min/1.73 m2)312349 - 93
  Hemoglobin312
    < 100 g/L14.1%30
    ≥ 100 g/L85.9%182
  Serum creatinine (µmol/L)31214763 - 626
  Hemoglobin (g/L)30712376 - 172
  Serum sodium (mmol/L)306139132 - 145
  Serum potassium (mmol/L)3064.52.6 - 6.2
  Serum bicarbonate (mmol/L)2652614 - 33
  Blood urea (mmol/L)28010.42.9 - 42.8
  Serum albumin (g/L)2953919.5 - 47
  Serum uric acid (µmol/L)289391117 - 879
  Total cholesterol2694.311.92 - 8.63
  HDL (mmol/L)2641.140.54 - 2.64
  LDL (mmol/L)2642.290.56 - 5.85
  Serum calcium (mmol/L)2182.382.16 - 2.76
  Ionized calcium (mmol/L)781.261.13 - 1.39
  Serum phosphate (mmol/L)2911.20.63 - 2.26
  C-reactive protein (mg/L)2415.52.03 - 293
  Ferritin (µg/L)279722.22 - 1022
  HbA1c (%)2755.84.8 - 11.3
  Absolute HbA1c (%)2737.34.1 - 15.1
  Urine albumin/creatinine ratio (mg/mmol)27010.20.24 - 1,414
  eGFR slope (mL/min/1.73 m3/day)306-0.00270-0.158 - 0.602
Radiology
  Right kidney (cm)2899.93.2 - 27.5
  Left kidney (cm)294105 - 28.2
  Average kidney (cm)2899.84.8 - 27.9
  Total kidney volume (mL3)294257.866 - 3,765.4

 

Table 2. Baseline Characteristics by CKD Grades
 
DemographicsCKD 1-2 (N = 19)CKD 3 (N = 112)CKD 4 (N = 66)CKD 5 (N = 15)
*P < 0.05. CKD: chronic kidney disease; BMI: body mass index; GERD: gastroesophageal reflux disease; COPD: chronic obstructive pulmonary disease; HbA1c: hemoglobin A1c; eGFR: estimated glomerular filtration rate; HDL: high-density lipoprotein; LDL: low-density lipoprotein; IQR: interquartile range.
Age (years)63.5 (29 - 92)72 (31 - 93)78 (37 - 93)74 (45 - 99)
Gender: male53% (10)60% (67)58% (38)57% (9)
Race
  Caucasian3.9%30.1%20.5%4.5%
  Arab2.9%4.8%3.2%0.64%
  Asian1.3%8.7%4.8%1.6%
  Black1.3%3.9%1.3%0
  European0.6%2.2%1.9%0.3%
  South American0.3%0.6%0.3%0.3%
Height (m)1.65 (IQR 1.03 - 1.9)1.68 (IQR 1.5 - 1.96)1.68 (IQR 1.47 - 1.96)1.67 (IQR 1.4 - 1.8)
Weight (kg)78.5 (IQR 53.3 - 130.6)80 (IQR 43 - 150)73.5 (IQR 34 - 131.5)77.7 (IQR 50.9 - 123.6)
BMI (kg/m2)28.3 (IQR 18.9 - 43.2)27.9 (IQR 17 - 53.2)27.2 (IQR 20.2 - 45.9)27.9 (IQR 20.3 - 43.8)
Comorbidities
  Diabetes mellitus*31.2%38.2%56%39.1%
  Dementia*3.13048.7
  Pacemaker0.322.562.880.32
  Gout0.965.776.730.96
  GERD1.925.771.280.96
  Atrial fibrillation0.966.414.810.32
  Peripheral vascular disease06.414.490.64
  Cerebrovascular disease0.964.174.490.32
  Coronary artery disease0.9613.788.972.24
  Congestive heart failure2.4 (1)47.6 (20)38.1 (16)11.9 (5)
  Cancer*18.8%29.3%34%43.5%
  Liver disease01.280.640.32
  COPD1.288.974.491.92
  Deep venous thrombosis0.323.210.640
  Dyslipidemia1.9217.6311.863.21
  Hematuria36.728.427.852.4
  Proteinuria*3031.360.890.5
  Hypothyroidism*9.4%11.5%15%17.4%
Clinic
  Systolic blood pressure (mm Hg)137 (IQR 101 - 188)142 (IQR 92 - 239)143 (IQR 88 - 195)139 (IQR 107 - 200)
  Diastolic blood pressure (mm Hg)76.5 (IQR 60 - 102)76 (IQR 49 - 102)71 (IQR 41 - 104)77 (IQR 40 - 100)
  Heart rate (beats/minute)73 (IQR 51 - 104)70 (IQR 49 - 123)70.5 (IQR 49 - 114)74 (IQR 62 - 106)
Laboratory
  Thyroid-stimulating hormone (µIU/L)1.6 (IQR 0.78 - 6.18)1.83 (IQR 0.18 - 109.5)1.8 (IQR 0.06 - 9.5)2.51 (IQR 0.26 - 6.39)
  eGFR (mL/min/1.73 m2)*67.5 (IQR 60 - 93)41 (IQR 30 - 59)24 (IQR 15 - 29)11 (IQR 9 - 14)
  Serum creatinine (µmol/L)88.5 (IQR 63 - 128)132 (IQR 80 - 193)208 (IQR 130 - 349)393 (IQR 241 - 626)
  Hemoglobin (g/L)*133 (IQR 102 - 162)127 (IQR 77 - 172)115 (IQR 82 - 171)106 (IQR 76 - 151)
  Serum sodium (mmol/L)139 (IQR 133 - 143)139 (IQR 127 - 148)138.5 (IQR 134 - 145)139 (IQR 133 - 142)
  Serum potassium (mmol/L)4.3 (IQR 3.7 - 4.9)4.5 (IQR 2.6 - 5.6)4.6 (IQR 3.4 - 6.2)4.8 (IQR 3 - 5.9)
  Serum bicarbonate (mmol/L)26.5 (IQR 21 - 30)26 (IQR 20 - 33)25 (IQR 14 - 31)23.5 (IQR 18 - 28)
  Blood urea (mmol/L)5.95 (IQR 2.9 - 16.2)8.7 (IQR 3.1 - 29)14.7 (IQR 6.7 - 28.7)19.6 (IQR 2.9 - 42.8)
  Serum albumin (g/L)*41.5 (IQR 34 - 46)41 (IQR 19.5 - 47)37 (IQR 23 - 46)36 (IQR 22 - 41)
  Serum uric acid (mmol/L)380 (IQR 235 - 588)397 (IQR 117 - 879)392 (IQR 225 - 690)409 (IQR 201 - 555)
  Total cholesterol (mmol/L)4.75 (IQR 2.77 - 7.33)4.43 (IQR 2.0 6- 7.32)3.98 (IQR 1.92 - 6.55)3.93 (IQR 2.39 - 11.65)
  HDL (mmol/L)1.18 (IQR 0.73 - 2.06)1.17 (IQR 0.54 - 2.02)1.08 (IQR 0.58 - 1.99)1.06 (IQR 0.6 - 2.71)
  LDL (mmol/L)2.61 (IQR 1.32 - 4.89)2.39 (IQR 0.02 - 5.55)2.06 (IQR 0.56 - 5.85)2.09 (IQR 1.08 - 8.5)
  Serum calcium (mmol/L)2.45 (IQR 2.25 - 2.46)2.39 (IQR 1.27 - 2.71)2.38 (IQR 1.19 - 2.76)2.39 (IQR 1.84 - 2.66)
  Ionized calcium (mmol/L)1.27 (IQR 1.16 - 1.32)1.25 (IQR 1.17 - 1.39)1.27 (IQR 1.17 - 1.41)1.27 (IQR 1.13 - 1.32)
  Serum phosphate (mmol/L)*1.26 (IQR 0.9 - 1.51)1.15 (IQR 0.63 - 1.73)1.29 (IQR 0.86 - 2.26)1.495 (IQR 0.95 - 2.26)
  C-reactive protein (mg/L)4 (IQR 2.03 - 18.8)4 (IQR 4 - 293)5.7 (IQR 4 - 122)6.7 (IQR 4 - 47.1)
  Ferritin (µg/L)*50 (IQR 10 - 417)71 (IQR 3 - 486)79 (IQR 7 - 1,022)119.5 (IQR 2.22 - 743)
  HbA1c (%)5.8 (IQR 5 - 9.6)5.7 (IQR 5.2 - 11.3)6.2 (IQR 5.2 - 9.6)5.5 (IQR 6 - 9)
  Absolute HbA1c (%)*7.6 (IQR 4.4 - 128)7.6 (IQR 5.3 - 15.1)7.2 (IQR 5 - 14.4)6.4 (IQR 4.1 - 9.9)
  Urine albumin/creatinine ratio (mg/mmol)*1.32 (IQR 0 - 324.14)5.13 (IQR 0 - 725.6)31.9(IQR 0 - 1,413.97)110.3 (IQR 5.2 - 978.8)
  eGFR slope (mL/min/1.73 m3/day)0.014 (IQR -1.03 - 0.102)-0.003 (IQR -0.158 - 0.246)0.00016 (IQR -0.15 - 0.60)-0.0019 (IQR - 0.014 to -0.016)
Radiology
  Right kidney (cm)11 (IQR 8.5 - 14.2)10.1 (IQR 5.2 - 24)9.5 (IQR 4.9 - 27.5)9.5 (IQR 3.2 - 11.8)
  Left kidney (cm)11 (IQR 6.6 - 14)10.3 (IQR 5.6 - 23)9.8 (IQR 5.9 - 28.2)9.3 (IQR 5 - 11.8)
  Average kidney (cm)10.8 (IQR 8.6 - 13.5)9.95 (IQR 4.8 - 23.5)9.65 (IQR 6.8 - 27.85)8.925 (IQR 5.6 - 11.8)
  Total kidney volume (mL3)238.3 (IQR 66 - 693.4)271 (IQR 75.2 - 1,707.4)338.4 (IQR 84.5 - 3,765.5)223.1 (IQR 112.7 - 445.1)

 

Table 3. Unadjusted Odds Ratio and Adjusted Multivariate Model for eGFR Slope
 
VariablesOdds ratio95% CIP value
*P < 0.05. CI: confidence interval. eGFR: estimated glomerular filtration rate; TSH: thyroid-stimulating hormone.
Unadjusted
  Baseline eGFR0.9990.998 - 1.0000.0976
  TSH > 5 µIU/L1.0070.989 - 1.0250.4311
  TSH ≤ 5 µIU/L (reference)1.0
  Systolic blood pressure (mm Hg)0.9990.999 - 1.0000.0028*
  Urine nephrotic range (g/L)0.9700.947 - 0.9940.0493*
  Urinalysis: urine overt proteinuria0.9860.971 - 1.002
  Urinalysis: urine trace proteinuria0.9880.969 - 1.007
  Urinalysis: reference negative proteinuria1.0
Adjusted multivariate model
  Baseline eGFR0.9990.998 - 1.0000.0029*
  TSH > 5 µIU/L1.0521.006 - 1.1000.0275*
  TSH ≤ 5 µIU/L (reference)1.0
  Systolic blood pressure (mm Hg)0.9990.999 - 1.0000.0066*
  Urine nephrotic range (g/L)0.9660.942 - 0.9900.0053*
  Urinalysis: urine overt proteinuria0.9850.969 - 1.0010.0754
  Urinalysis: urine trace proteinuria0.9830.964 - 1.0020.0873
  Urinalysis: reference negative proteinuria1.0

 

Table 4. Unadjusted Odds Ratio and Multivariate Adjusted GLM Model for Urine Albumin/Creatinine Ratio
 
VariableOdds ratio95% CIP value
*P < 0.05. GLM: generalized linear model; CI: confidence interval. eGFR: estimated glomerular filtration rate; TSH: thyroid-stimulating hormone.
Unadjusted
  TSH > 1.8 µIU/L1.021.01 - 1.080.0129*
  History of diabetes0.980.91 - 0.990.0017*
  Systolic blood pressure5.161.94 - 13.60.0011*
  eGFR0.030.01 - 0.15< 0.0001*
Multivariate adjusted GLM model
  TSH > 1.8 µIU/L1.021.01 - 1.230.0312*
  History of diabetes0.980.83 - 0.990.0292*
  Systolic blood pressure3.671.43 - 9.490.0071*
  eGFR0.060.01 - 0.240.0001*