title: Associations of triiodothyronine levels with carotid atherosclerosis and arterial stiffness in hemodialysis patients.
abstract: OBJECTIVE
  End-stage renal disease is linked to alterations in thyroid hormone levels and/or metabolism, resulting in a high prevalence of subclinical hypothyroidism and low triiodothyronine (T3) levels. These alterations are involved in endothelial damage, cardiac abnormalities, and inflammation, but the exact mechanisms are unclear. In this study, we investigated the relationship between serum free-T3 (fT3) and carotid artery atherosclerosis, arterial stiffness, and vascular calcification in prevalent patients on conventional hemodialysis.
  
  
  METHODS
  137 patients were included. Thyroid-hormone levels were determined by chemiluminescent immunoassay, carotid artery-intima media thickness (CA-IMT) by Doppler ultrasonography, carotid-femoral pulse wave velocity (c-f PWV), and augmentation index by Sphygmocor device, and coronary artery calcification (CAC) scores by multi-slice computerized tomography.
  
  
  RESULTS
  Mean fT3 level was 3.70 ± 1.23 pmol/L. Across decreasing fT3 tertiles, c-f PWV and CA-IMT values were incrementally higher, whereas CACs were not different. In adjusted ordinal logistic regression analysis, fT3 level (odds ratio, 0.81; 95% confidence interval, 0.68 to 0.97), age, and interdialytic weight gain were significantly associated with CA-IMT. fT3 level was associated with c-f PWV in nondiabetics but not in diabetics. In nondiabetics (n = 113), c-f PWV was positively associated with age and systolic BP but negatively with fT3 levels (odds ratio = 0.57, 95% confidence interval 0.39 to 0.83).
  
  
  CONCLUSIONS
  fT3 levels are inversely associated with carotid atherosclerosis but not with CAC in hemodialysis patients. Also, fT3 levels are inversely associated with surrogates of arterial stiffness in nondiabetics.
authors.affiliation: Ege University School of Medicine, Division of Nephrology, 35100, Bornova, Izmir, Turkey. etatar@hotmail.com
authors.forename: Erhan
authors.initials: E
authors.lastname: Tatar
authors.forename: Fatih
authors.initials: F
authors.lastname: Kircelli
authors.forename: Gulay
authors.initials: G
authors.lastname: Asci
authors.forename: Juan Jesus
authors.initials: JJ
authors.lastname: Carrero
authors.forename: Ozkan
authors.initials: O
authors.lastname: Gungor
authors.forename: Meltem Sezis
authors.initials: MS
authors.lastname: Demirci
authors.forename: Suha Sureyya
authors.initials: SS
authors.lastname: Ozbek
authors.forename: Naim
authors.initials: N
authors.lastname: Ceylan
authors.forename: Mehmet
authors.initials: M
authors.lastname: Ozkahya
authors.forename: Huseyin
authors.initials: H
authors.lastname: Toz
authors.forename: Ercan
authors.initials: E
authors.lastname: Ok
mesh_terms: D002340:Carotid Artery Diseases / Q000097:blood*; D059168:Carotid Intima-Media Thickness; D003324:Coronary Artery Disease / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D006435:Renal Dialysis; D014284:Triiodothyronine / Q000097:blood*; D061205:Vascular Calcification / Q000097:blood; D059289:Vascular Stiffness
chemical_list: D014284:Triiodothyronine