Effects of hypothyroidism and serum FGF23 on cardiovascular disease in maintenance hemodialysis patients
Objective To explore the relationship between cardiovascular disease,hypothyroid-ism and serum fibroblast growth factor 23 (FGF) in maintenance hemodialysis (MHD) patients,in order to provide reference for clinical prevention of cardiovascular disease in MHD patients.Methods One hundred and twenty-four patients with MHD were admitted to our hospital from February 2020 to December 2022 and were selected for the cross-sectional study (MHD group).Another 50 healthy individuals who underwent physical examinations in our hospital during the same period were selected as the healthy control group.Serum FGF23 levels,free triiodothyronine FT3 (FT3),free tetraiodothyronine FT4 (FT4),and thyroid-stimulating hormone (TSH) levels were compared between the MHD group and the healthy control group.The 124 MHD patients were classified into 53 patients in the cardiovascular lesion group (with cardiovascular lesions) and 71 patients in the non-cardiovascular lesion group (without cardiovascular lesions) based on the occurrence of car-diovascular lesions recorded by telephone or outpatient follow-up;Multivariate logistic regression was used to analyse the risk factors for cardiovascular lesions in the MHD group.The correlation between thyroid function indexes,FGF23 levels and cardiovascular lesions in the cardiovascular lesion group was also analyzed.Results The levels of FT3 and FT4 in the MHD group were lower than those in the healthy control group,awhile the levels of FGF23 and TSH in the MHD group were higher than those in the healthy control group (P<0.05).Comparison of gender,age,dialysis vascular access,disease duration,and body mass index between the car-diovascular lesion group and the non-cardiovascular lesion group showed no statistically significant difference (P>0.05).However,comparisons of hypertension,diabetes mellitus,FT3,FT4,TSH,and FGF23 levels,carotid intima-media thickness (IMT),and left ventricular mass index (LVMI) between the two groups showed statistically significant differences (P<0.05).The results of multivariate logistic regression analysis showed that hypertension,diabetes mellitus,TSH,FGF23,LVMI,elevated IMT,and reduced FT3 and FT4 were risk factors for cardiovascular lesions in patients with MHD (P<0.05).Patients in the cardiovascular le-sion group exhibited a positive correlation between TSH and FGF23 and IMT and LVMI,and a negative corre-lation between FT3 and FT4 and IMT and LVMI (P<0.05).Conclusion Hypothyroidism and elevated FGF23 leves are risk factors for cardiovascular disease in MHD patients.Regular monitoring of thyroid func-tion and FGF23 levels can help reduce the risk of cardiovascular disease.
万方数据
维普
