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Abstract: TH-PO457

Thyroid Status and Coronary Artery Calcification in a Prospective Hemodialysis Cohort

Session Information

Category: Hypertension and CVD

  • 1401 Hypertension and CVD: Epidemiology, Risk Factors, and Prevention

Authors

  • Rhee, Connie, University of California, Irvine, Orange, California, United States
  • Novoa, Alejandra, UC Irvine Health, Orange, California, United States
  • You, Amy Seung, University of California, Irvine, Orange, California, United States
  • Nakata, Tracy, University of California, Irvine, Orange, California, United States
  • Kalantar-Zadeh, Kamyar, University of California Irvine, School of Medicine, Orange, California, United States
Background

In the general population, hypothyroidism is a known risk factor for coronary heart disease (CHD) and death. Experimental data suggest that low levels of circulating thyroid hormone (e.g., triiodothyronine [T3]) are causally associated with vascular calcification via downregulation of matrix Gla and klotho (i.e., vascular calcification inhibitors), and human studies suggest that low T3 levels are associated with higher risk of coronary artery calcification (CAC). However, little is known about the association of thyroid status, defined by serum thyrotropin (TSH) as the most sensitive and specific biochemical metric of thyroid function, with risk of CAC in the hemodialysis population.

Methods

In a secondary analysis of 104 patients from the Anti-Inflammatory and Anti-Oxidative Nutrition in Hypoalbuminemic Dialysis Patients (AIONID) trial, we examined the association of serum TSH levels with total Agatston CAC score. Cross-sectional associations of thyroid status with CAC score (total Agatston score >100, threshold for which moderate non-obstructive coronary artery disease highly likely) were estimated using logistic regression models adjusted for age, sex, and race.

Results

We observed that increasingly higher increments of serum TSH (defined as change in 1 standard deviation = 1.9mIU/L) were associated with a 3-fold higher risk of higher CAC score: OR (95%CI) 3.05 (1.26-7.37). When categorized as tertiles, the highest TSH tertile was also associated with a higher risk of higher CAC burden (ref: lowest tertile): OR (95%CI) 5.53 (1.44-26.3). Similarly TSH levels >3mIU/L were associated with a higher risk of higher CAC score (ref: ≤3mIU/L): OR (95%CI) 10.82 (1.78-65.8).

Conclusion

These data indicate that higher serum TSH levels are associated with higher risk of CAC in hemodialysis patients. Further studies are needed to determine of thyroid hormone supplementation ameliorates CHD burden in this population.

Funding

  • NIDDK Support