Possible relations between thyroid function, endothelium, and kidney and liver function in kidney allograft recipients.
BACKGROUND
Renal function affects the thyroid gland in many ways. Disturbances in hemostasis and endothelial damage are common complications of kidney disease. Endothelial dysfunction may link these two processes.


OBJECTIVE
This cross-sectional study examined thyroid hormones in relation to markers of endothelial damage and inflammation among 80 kidney allograft recipients and 29 healthy volunteers. Thyroid hormones, markers of endothelial damage (vWF, thrombomodulin, intracellular adhesion molecule [ICAM] vascular adhesion molecule [VCAM], CD146), markers of inflammation (hsCRP), other hemostatic parameters (thrombin-antithrombin complexes [TAT], prothrombin fragments 1 + 2 [F1 + 2], plasmin-antiplasmin complexes, tissue plasminogen activator and its inhibitor, platelet glycoprotein [V-GPV]) as well as P-selectin were measured using commercially available kits.


RESULTS
Total T3 was significantly lower among kidney allograft recipients, whereas markers of endothelial dysfunction and inflammation were significantly elevated over controls. In kidney allograft recipients total T3 was independently related to PAI-1, ICAM, and eGFR, whereas free T3 was independently related to thrombomodulin, aspartate, and alanine aminotransferases, hemoglobin, urea, eGFR, dose of cyclosporine and treatment with mycophenolate mofetil/azathioprine. Total T4 was related to aspartate and alanine aminotransferases, dose of cyclosporine, PAI-1, and ICAM. In multiple regression analysis the only correlates of T3 were PAI-1 and ICAM, whereas the only correlates of free T3 were thrombomodulin, aspartate aminotransferase, eGFR, and cyclosporine dose. In healthy volunteers GPV was related only to TSH.


CONCLUSIONS
We described novel relations between thyroid hormones and markers of endothelial dysfunction in kidney transplant recipients. In kidney transplant recipients thyroid function metrics were associated with endothelial damage, immunosuppressive treatment, liver and kidney function. Therefore, the relations between thyroid axis and endothelium in kidney allograft recipients merit additional studies.
Malyszko
J
J
Department of Nephrology and Transplantology, Medical University, Bialystok, Poland. jolmal@poczta.onet.pl
Malyszko
J S
JS
Pawlak
K
K
Mysliwiec
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000410:Alanine Transaminase; D001219:Aspartate Aminotransferases; D015415:Biomarkers / Q000097:blood; D003430:Cross-Sectional Studies; D004730:Endothelium, Vascular / Q000502:physiology*; D006801:Humans; D007677:Kidney Function Tests; D016030:Kidney Transplantation / Q000502:physiology*; D008111:Liver Function Tests; D008875:Middle Aged; D012016:Reference Values; D013960:Thyroid Function Tests; D013961:Thyroid Gland / Q000502:physiology*; D013963:Thyroid Hormones / Q000097:blood; D014184:Transplantation, Homologous
D015415:Biomarkers; D013963:Thyroid Hormones; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase