Abstract: SA-PO156

Thyroid Status and Body Composition in a Prospective Hemodialysis Cohort

Session Information

Category: Nutrition, Inflammation, and Metabolism

  • 1401 Nutrition, Inflammation, Metabolism

Authors

  • Rhee, Connie, University of California Irvine, Huntington Beach, California, United States
  • Nguyen, Danh V., University of California, Irvine, Orange, California, United States
  • Chen, Yanjun, University of California Irvine, Huntington Beach, California, United States
  • You, Amy Seung, University of California, Irvine, Orange, California, United States
  • Kovesdy, Csaba P., University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Budoff, Matthew Jay, UCLA School of Medicine, Torrance, California, United States
  • Nakata, Tracy, UC Irvine, Orange, California, United States
  • Novoa, Alejandra, University of California, Irvine, Orange, California, United States
  • Brent, Gregory, VA Greater Los Angeles Healthcare, Los Angeles, California, United States
  • Kalantar-Zadeh, Kamyar, University of California Irvine, School of Medicine, Orange, California, United States
Background

Thyroid status is known to control metabolism, with subsequent effect upon body composition. In addition to causing excess adiposity, hypothyroidism also increases development and growth of skeletal muscle. Whereas hypothyroidism is highly prevalent in hemodialysis (HD) patients, there has not been prior study of thyroid status and trajectory of body composition parameters in this population.

Methods

Among 590 HD patients from the prospective Malnutrition, Diet, and Racial Disparities in Kidney Disease study, we examined the association of thyroid status, defined by baseline serum TSH, with body composition parameters over time using case-mix+laboratory linear mixed effects models. Over 2013-17, patients were recruited from 17 outpatient HD facilities and underwent protocolized TSH testing and body anthropometry testing: subcutaneous fat (biceps and triceps skinfold [SF]); skeletal muscle (mid-arm circumference [MAC], mid-arm muscle circumference [MAMC]; total body fat (near infra-red [NIR] body fat); and visceral fat (waist circumference).

Results

Higher TSH levels were incrementally associated with greater biceps SF (ref: TSH <1mIU/L): β=+0.8mm (p=0.03) and β=+1.2mm (p=0.02) for TSH levels 1-3 and >3mIU/L, respectively (Figure). Similarly, incrementally higher TSH levels were associated with greater NIR body fat: β=+0.4% (p=0.13) and β=+0.8% (p=0.04) for TSH levels 1-3 and >3mIU/L, respectively. There was a trend between higher TSH levels and higher MAC: β=+0.3cm (p=0.15) and β=+0.5cm (p=0.06) for TSH levels 1-3 and >3mIU/L, respectively.

Conclusion

In HD patients higher TSH levels are associated with greater markers of subcutaneous and total body fat, and may potentially be associated with greater muscle mass. Future studies are needed to determine if thyroid-modulating therapy alters the body composition of hypothyroid HD patients.

Funding

  • NIDDK Support