Role of Microalbuminuria in Predicting Cardiovascular Mortality in Individuals With Subclinical Hypothyroidism

Tushar A. Tuliani, Maithili Shenoy, Kevin Belgrave, Abhishek Deshmukh, Sadip Pant, Anthony Hilliard, Luis Afonso

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Purpose Studies suggest that subclinical hypothyroidism (SCH) is related to cardiovascular mortality (CVM). We explored the role of microalbuminuria (MIA) as a predictor of long-term CVM in population with and without SCH with normal kidney function. Materials and Methods We examined the National Health and Nutrition Education Survey - III database (n = 6,812). Individuals younger than 40 years, thyroid-stimulating hormone levels ≥20 and ≤0.35 mIU/L, estimated glomerular filtration rate <60 mL/minute/1.73 m2 and urine albumin-to-creatinine ratio of >250 mg/g in men and >355 mg/g in women were excluded. SCH was defined as thyroid-stimulating hormone levels between 5 and 19.99 mIU/L and serum T4 levels between 5 and 12 µg/dL. MIA was defined as urine albumin-to-creatinine ratio of 17-250 mg/g in men and 25-355 mg/g in women. Patients were categorized into the following 4 groups: (1) no SCH or MIA, (2) MIA, but no SCH, (3) SCH, but no MIA and (4) both SCH and MIA. Results Prevalence of MIA in the subclinical hypothyroid cohort was 21% compared to 16.4% in those without SCH (P = 0.03). SCH was a significant independent predictor of MIA (n = 6,812), after adjusting for traditional risk factors (unadjusted odds ratio = 1.75; 95% CI: 1.24-2.48; P = 0.002 and adjusted odds ratio = 1.83; 95% CI: 1.2-2.79; P = 0.006). MIA was a significant independent predictor of long-term all-cause (adjusted hazard ratio = 1.7, 95% CI: 1.24-2.33) and CVM (adjusted hazard ratio = 1.72, 95% CI: 1.07-2.76) in subclinical hypothyroid individuals. Conclusions In a cohort of subclinical hypothyroid individuals, the presence of MIA predicts increased risk of CVM as compared to nonmicroalbuminurics with SCH. Further randomized trials are needed to assess the benefits of treating microalbuminuric subclinical hypothyroid individuals and impact on CVM.

Original languageEnglish
Pages (from-to)285-290
Number of pages6
JournalAmerican Journal of the Medical Sciences
Volume354
Issue number3
DOIs
Publication statusPublished - 01-09-2017
Externally publishedYes

Fingerprint

Hypothyroidism
Mortality
Thyrotropin
Odds Ratio
Nutrition Surveys
Glomerular Filtration Rate
Health Education
Albumins
Creatinine
Urine
Databases
Kidney

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Tuliani, Tushar A. ; Shenoy, Maithili ; Belgrave, Kevin ; Deshmukh, Abhishek ; Pant, Sadip ; Hilliard, Anthony ; Afonso, Luis. / Role of Microalbuminuria in Predicting Cardiovascular Mortality in Individuals With Subclinical Hypothyroidism. In: American Journal of the Medical Sciences. 2017 ; Vol. 354, No. 3. pp. 285-290.
@article{ab96569747f44548a437c677224dac41,
title = "Role of Microalbuminuria in Predicting Cardiovascular Mortality in Individuals With Subclinical Hypothyroidism",
abstract = "Purpose Studies suggest that subclinical hypothyroidism (SCH) is related to cardiovascular mortality (CVM). We explored the role of microalbuminuria (MIA) as a predictor of long-term CVM in population with and without SCH with normal kidney function. Materials and Methods We examined the National Health and Nutrition Education Survey - III database (n = 6,812). Individuals younger than 40 years, thyroid-stimulating hormone levels ≥20 and ≤0.35 mIU/L, estimated glomerular filtration rate <60 mL/minute/1.73 m2 and urine albumin-to-creatinine ratio of >250 mg/g in men and >355 mg/g in women were excluded. SCH was defined as thyroid-stimulating hormone levels between 5 and 19.99 mIU/L and serum T4 levels between 5 and 12 µg/dL. MIA was defined as urine albumin-to-creatinine ratio of 17-250 mg/g in men and 25-355 mg/g in women. Patients were categorized into the following 4 groups: (1) no SCH or MIA, (2) MIA, but no SCH, (3) SCH, but no MIA and (4) both SCH and MIA. Results Prevalence of MIA in the subclinical hypothyroid cohort was 21{\%} compared to 16.4{\%} in those without SCH (P = 0.03). SCH was a significant independent predictor of MIA (n = 6,812), after adjusting for traditional risk factors (unadjusted odds ratio = 1.75; 95{\%} CI: 1.24-2.48; P = 0.002 and adjusted odds ratio = 1.83; 95{\%} CI: 1.2-2.79; P = 0.006). MIA was a significant independent predictor of long-term all-cause (adjusted hazard ratio = 1.7, 95{\%} CI: 1.24-2.33) and CVM (adjusted hazard ratio = 1.72, 95{\%} CI: 1.07-2.76) in subclinical hypothyroid individuals. Conclusions In a cohort of subclinical hypothyroid individuals, the presence of MIA predicts increased risk of CVM as compared to nonmicroalbuminurics with SCH. Further randomized trials are needed to assess the benefits of treating microalbuminuric subclinical hypothyroid individuals and impact on CVM.",
author = "Tuliani, {Tushar A.} and Maithili Shenoy and Kevin Belgrave and Abhishek Deshmukh and Sadip Pant and Anthony Hilliard and Luis Afonso",
year = "2017",
month = "9",
day = "1",
doi = "10.1016/j.amjms.2017.04.022",
language = "English",
volume = "354",
pages = "285--290",
journal = "American Journal of the Medical Sciences",
issn = "0002-9629",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

Role of Microalbuminuria in Predicting Cardiovascular Mortality in Individuals With Subclinical Hypothyroidism. / Tuliani, Tushar A.; Shenoy, Maithili; Belgrave, Kevin; Deshmukh, Abhishek; Pant, Sadip; Hilliard, Anthony; Afonso, Luis.

In: American Journal of the Medical Sciences, Vol. 354, No. 3, 01.09.2017, p. 285-290.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Role of Microalbuminuria in Predicting Cardiovascular Mortality in Individuals With Subclinical Hypothyroidism

AU - Tuliani, Tushar A.

AU - Shenoy, Maithili

AU - Belgrave, Kevin

AU - Deshmukh, Abhishek

AU - Pant, Sadip

AU - Hilliard, Anthony

AU - Afonso, Luis

PY - 2017/9/1

Y1 - 2017/9/1

N2 - Purpose Studies suggest that subclinical hypothyroidism (SCH) is related to cardiovascular mortality (CVM). We explored the role of microalbuminuria (MIA) as a predictor of long-term CVM in population with and without SCH with normal kidney function. Materials and Methods We examined the National Health and Nutrition Education Survey - III database (n = 6,812). Individuals younger than 40 years, thyroid-stimulating hormone levels ≥20 and ≤0.35 mIU/L, estimated glomerular filtration rate <60 mL/minute/1.73 m2 and urine albumin-to-creatinine ratio of >250 mg/g in men and >355 mg/g in women were excluded. SCH was defined as thyroid-stimulating hormone levels between 5 and 19.99 mIU/L and serum T4 levels between 5 and 12 µg/dL. MIA was defined as urine albumin-to-creatinine ratio of 17-250 mg/g in men and 25-355 mg/g in women. Patients were categorized into the following 4 groups: (1) no SCH or MIA, (2) MIA, but no SCH, (3) SCH, but no MIA and (4) both SCH and MIA. Results Prevalence of MIA in the subclinical hypothyroid cohort was 21% compared to 16.4% in those without SCH (P = 0.03). SCH was a significant independent predictor of MIA (n = 6,812), after adjusting for traditional risk factors (unadjusted odds ratio = 1.75; 95% CI: 1.24-2.48; P = 0.002 and adjusted odds ratio = 1.83; 95% CI: 1.2-2.79; P = 0.006). MIA was a significant independent predictor of long-term all-cause (adjusted hazard ratio = 1.7, 95% CI: 1.24-2.33) and CVM (adjusted hazard ratio = 1.72, 95% CI: 1.07-2.76) in subclinical hypothyroid individuals. Conclusions In a cohort of subclinical hypothyroid individuals, the presence of MIA predicts increased risk of CVM as compared to nonmicroalbuminurics with SCH. Further randomized trials are needed to assess the benefits of treating microalbuminuric subclinical hypothyroid individuals and impact on CVM.

AB - Purpose Studies suggest that subclinical hypothyroidism (SCH) is related to cardiovascular mortality (CVM). We explored the role of microalbuminuria (MIA) as a predictor of long-term CVM in population with and without SCH with normal kidney function. Materials and Methods We examined the National Health and Nutrition Education Survey - III database (n = 6,812). Individuals younger than 40 years, thyroid-stimulating hormone levels ≥20 and ≤0.35 mIU/L, estimated glomerular filtration rate <60 mL/minute/1.73 m2 and urine albumin-to-creatinine ratio of >250 mg/g in men and >355 mg/g in women were excluded. SCH was defined as thyroid-stimulating hormone levels between 5 and 19.99 mIU/L and serum T4 levels between 5 and 12 µg/dL. MIA was defined as urine albumin-to-creatinine ratio of 17-250 mg/g in men and 25-355 mg/g in women. Patients were categorized into the following 4 groups: (1) no SCH or MIA, (2) MIA, but no SCH, (3) SCH, but no MIA and (4) both SCH and MIA. Results Prevalence of MIA in the subclinical hypothyroid cohort was 21% compared to 16.4% in those without SCH (P = 0.03). SCH was a significant independent predictor of MIA (n = 6,812), after adjusting for traditional risk factors (unadjusted odds ratio = 1.75; 95% CI: 1.24-2.48; P = 0.002 and adjusted odds ratio = 1.83; 95% CI: 1.2-2.79; P = 0.006). MIA was a significant independent predictor of long-term all-cause (adjusted hazard ratio = 1.7, 95% CI: 1.24-2.33) and CVM (adjusted hazard ratio = 1.72, 95% CI: 1.07-2.76) in subclinical hypothyroid individuals. Conclusions In a cohort of subclinical hypothyroid individuals, the presence of MIA predicts increased risk of CVM as compared to nonmicroalbuminurics with SCH. Further randomized trials are needed to assess the benefits of treating microalbuminuric subclinical hypothyroid individuals and impact on CVM.

UR - http://www.scopus.com/inward/record.url?scp=85030438385&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85030438385&partnerID=8YFLogxK

U2 - 10.1016/j.amjms.2017.04.022

DO - 10.1016/j.amjms.2017.04.022

M3 - Article

VL - 354

SP - 285

EP - 290

JO - American Journal of the Medical Sciences

JF - American Journal of the Medical Sciences

SN - 0002-9629

IS - 3

ER -