Correlation between thyroid autoantibodies and cardiovascular disease in patients with stages 3-5 chronic kidney disease

Weicheng Xu; Shiyi Liang; Yuxiang Huang; Shili Zhao; Yunfang Zhang; Yongqiang Li

doi:10.21037/atm-21-3280

Correlation between thyroid autoantibodies and cardiovascular disease in patients with stages 3-5 chronic kidney disease

Ann Transl Med. 2021 Aug;9(16):1301. doi: 10.21037/atm-21-3280.

Authors

Weicheng Xu^{1

2}, Shiyi Liang¹, Yuxiang Huang³, Shili Zhao², Yunfang Zhang², Yongqiang Li³

Affiliations

¹ Department of Nephrology, Institute of Nephrology and Urology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China.
² Department of Nephrology, Huadu District People's Hospital, Southern Medical University, Guangzhou, China.
³ Department of General Practice, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China.

Abstract

Background: Chronic kidney disease (CKD) is associated with thyroid disease and cardiovascular disease (CVD). To date, little is known about the association of thyroid autoantibodies with renal function or cardiac function in patients with CKD.

Methods: This is a descriptive cross-sectional study. Patients diagnosed with stages 3-5 CKD from January 2015 to May 2019 at our department were recruited. Routine medical history, general clinical data, and laboratory test indexes were collected for all patients. Echocardiography was performed by a trained echocardiographer to measure E in early diastole and A, E/A ratio, E' in early diastole, A' in end-diastole, E/E' ratio, and E'/A' ratio.

Results: A total of 1,164 patients with stages 3-5 CKD were included. Thyrotropin receptor antibody (TRAb) was significantly positively correlated with C-reactive protein (r=0.206, P<0.001). Thyroid peroxidase antibody (TPOAb) and TGAb titers in male diabetic patients were higher (r=0.137, P=0.023; r=0.159, P=0.011). In female patients, both TPOAb and TGAb were significantly negatively correlated with hemoglobin (r=-0.213, P=0.018; r=-0.188, P=0.019). The E/E' of patients who were TPOAb positive was higher than that in patients with TPOAb negative (r=0.181, P<0.001). LVEF in patients who were TPOAb positive was higher than that in patients with TPOAb negative (r=0.159, P=0.007). In addition, LVEF was significantly negatively correlated with TRAb (r=-0.112, P=0.026).

Conclusions: In patients with stages 3-5 CKD, AITD may increase the risk of CVD in CKD patients by affecting triglycerides levels, increasing the risk of anemia, and promoting micro-inflammation. Attention should be paid to female patients with high TPOAb and TGAb titers. The mean of E/E' in patients with stage 5 CKD was 16.89 in the present study. Women with TPOAb positive may be more likely to develop diastolic heart failure.

Keywords: Chronic kidney disease (CKD); cardiovascular disease (CVD); echocardiography; thyroid autoantibodies.