Clinical prognosis of patients with CKD complicated with coronary heart disease based on thyroxine and thyroid-binding globulin
10.3969/j.issn.1673-4130.2025.05.015
- VernacularTitle:基于甲状腺素与甲状腺结合球蛋白探讨CKD合并冠心病患者的临床预后
- Author:
Lina ZHOU
1
;
Meiying ZHOU
Author Information
1. 湖北省直属机关医院/湖北省康复医院检验科,湖北 武汉 430064
- Keywords:
thyroxine;
thyroid-binding globulin;
coronary heart disease;
chronic kidney disease;
prognosis
- From:
International Journal of Laboratory Medicine
2025;46(5):585-588,594
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the value of thyroid hormone in predicting the prognosis of patients with chronic kidney disease(CKD)complicated with coronary heart disease.Methods The clinical data of 254 patients with coronary heart disease who underwent coronary angiography in the hospital directly under Hubei Province from January to December 2018 were analyzed.The serum levels of thyroid stimulating hormone(TSH),thyroxine(T4),free thyroxine(fT4),triiodothyronine(T3),free triiodothyronine(fT3)and thyroid-binding globulin(TBG)were measured by automatic chemiluminescence immunoassay.The estimated glo-merular filtration rate(eGFR)of each patient was calculated by the kidney disease formula.After the baseline survey,patients were followed until the end of the study or the end of the observation period.Multivariate Lo-gistic regression was used to analyze the influencing factors of CKD progression.Receiver operating character-istic(ROC)curve was used to analyze the value of serum T4,TBG levels and their combination in predicting the progression of CKD.Results Among the 254 patients enrolled,the incidence of renal function decline was 15.75%,and they were included in the progression group(n=40),and the rest were included in the non-pro-gression group(n=214).Compared with the non-progression group,the progression group had significantly lower levels of hemoglobin,T4,and TBG(P<0.05)and significantly higher levels of triglyceride,low-density lipoprotein,and proteinuria(P<0.05).Multivariate Logistic regression analysis showed that both serum T4 and TBG were risk factors for renal function decline in patients with CKD complicated with coronary heart disease(P<0.05).Compared with patients with eGFR≥90 mL/(min·1.73 m2),patients with eGFR<30,30-<60,60-<90 mL/(min·1.73 m2)had lower serum TBG levels(P<0.05).Patients with eGFR<30 mL/(min·1.73 m2)and 30-<60 mL/(min·1.73 m2)had lower serum T4 levels(P<0.05).Serum T4 and TBG levels were positively correlated with eGFR(r=0.178,0.300,P<0.01).The area under the curve of serum T4 combined with TBG for predicting CKD progression was 0.849(95%CI 0.800-0.899).Conclu-sion Low serum T4 and TBG levels are closely related to the progression of CKD in patients with CKD com-plicated with coronary heart disease.
