title: The cardiovascular disease risks of nonthyroidal illness syndrome and inflammatory responses on patients with chronic kidney disease: from the association to clinical prognosis.
abstract: BACKGROUND
  Previous data have suggested the potential risk of low serum-free triiodothyronine (FT3) on the cardiovascular disease (CVD) events in patients with end-stage renal disease (ESRD). However, the roles of FT3 and interleukin-6 (IL-6) in the developing of CVD events in patients with chronic kidney disease (CKD) have not been investigated.
  
  
  METHODS
  A total of 176 consecutive patients with CKD underwent thyroid function, IL-6, and echocardiography evaluation. They were divided into two subgroups: group I, 77 patients with IL-6 >200 ng/L, and group II, 99 patients with IL-6 <200 ng/L. The total patients were also divided into two subgroups according to their serum FT3: group A, 83 patients with FT3 <4.0 pmol/L, and group B, 93 patients with FT3 >4.0 pmol/L.
  
  
  RESULTS
  Serum FT3 (β = -0.21, P < 0.01), IL-6 (β = 0.48, P < 0.01), and glutathione peroxidase (GSH-Px, β = -0.58, P < 0.01) were found independently associated with left ventricular mass index (LVMI). Patients with higher IL-6 had significantly higher CVD incidence than those with IL-6 <200 ng/L (HR 1.98, P = 0.014); Patients with lower FT3 had significantly higher CVD incidence than those with FT3 >4.0 pmol/L (HR 1.81, P = 0.038), when extensive demographics, comorbidities and laboratory adjustments were made.
  
  
  CONCLUSIONS
  Serum levels of FT3 and IL-6 were associated with the LVMI and previous CVD events; lower FT3 and higher IL-6 were strong predictors of subsequent CVD events in patients with CKD.
authors.affiliation: Department of Nephrology, Second Affiliated Hospital, Nanchang University, Nanchang, China.
authors.forename: Gaosi
authors.initials: G
authors.lastname: Xu
authors.forename: Yan
authors.initials: Y
authors.lastname: Yan
authors.forename: Yanna
authors.initials: Y
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology*; D004452:Echocardiography; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000209:etiology; D007249:Inflammation / Q000276:immunology; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000150:complications*; D012306:Risk; D014284:Triiodothyronine / Q000097:blood*
chemical_list: C508600:IL6 protein, human; D015850:Interleukin-6; D014284:Triiodothyronine
keywords: Cardiovascular disease; Free triiodothyronine; Interleukin-6; Nonthyroidal illness syndrome