Login to MyKarger

New to MyKarger? Click here to sign up.



Login with Facebook

Forgot your password?

Authors, Editors, Reviewers

For Manuscript Submission, Check or Review Login please go to Submission Websites List.

Submission Websites List

Institutional Login
(Shibboleth or Open Athens)

For the academic login, please select your country in the dropdown list. You will be redirected to verify your credentials.

Original Report: Laboratory Investigation

Low Triiodothyronine Alters Flow-Mediated Vasodilatation in Advanced Nondiabetic Kidney Disease

Yilmaz M.I.a · Sonmez A.b · Karaman M.c · Ay S.A.c · Saglam M.d · Yaman H.e · Kilic S.f · Eyileten T.a · Caglar K.a · Oguz Y.a · Vural A.a · Yenicesu M.a · Zoccali C.g

Author affiliations

Departments of aNephrology, bEndocrinology, cInternal Medicine, dRadiology, eBiochemistry and fEpidemiology, Gülhane School of Medicine, Ankara, Turkey; gDepartment of Nephrology, Hypertension and Renal Transplantation, CNR-IBIM Clinical Epidemiology of Renal Diseases and Hypertension, Ospedali Riuniti, Reggio Calabria, Italy

Related Articles for ""

Am J Nephrol 2011;33:25–32

Do you have an account?

Login Information





Contact Information










I have read the Karger Terms and Conditions and agree.



Login Information





Contact Information










I have read the Karger Terms and Conditions and agree.



To view the fulltext, please log in

To view the pdf, please log in

Buy

  • FullText & PDF
  • Unlimited re-access via MyKarger
  • Unrestricted printing, no saving restrictions for personal use
read more

CHF 38.00 *
EUR 35.00 *
USD 39.00 *

Select

KAB

Buy a Karger Article Bundle (KAB) and profit from a discount!

If you would like to redeem your KAB credit, please log in.


Save over 20% compared to the individual article price.
Learn more

Rent/Cloud

  • Rent for 48h to view
  • Buy Cloud Access for unlimited viewing via different devices
  • Synchronizing in the ReadCube Cloud
  • Printing and saving restrictions apply

Rental: USD 8.50
Cloud: USD 20.00


Select

Subscribe

  • Access to all articles of the subscribed year(s) guaranteed for 5 years
  • Unlimited re-access via Subscriber Login or MyKarger
  • Unrestricted printing, no saving restrictions for personal use
read more

Subcription rates


Select

* The final prices may differ from the prices shown due to specifics of VAT rules.

Article / Publication Details

First-Page Preview
Abstract of Original Report: Laboratory Investigation

Received: September 29, 2010
Accepted: November 05, 2010
Published online: December 09, 2010
Issue release date: January 2011

Number of Print Pages: 8
Number of Figures: 3
Number of Tables: 2

ISSN: 0250-8095 (Print)
eISSN: 1421-9670 (Online)

For additional information: https://www.karger.com/AJN

Abstract

Background/Aims: Subclinical or frank hypothyroidism is causally implicated in endothelial dysfunction. Since the plasma concentration of the active form of thyroid hormone, triiodothyronine (T3), is reduced in chronic kidney disease (CKD), where endothelial function is frequently altered, low T3 may be a factor implicated in this disturbance in CKD patients. Methods: We investigated the relationship between flow-mediated vasodilatation (FMD) and thyroid hormones in a series of 217 nondiabetic patients with stage 3–4 CKD. Results: The plasma concentration of free T3 (fT3) was closely associated with FMD (r = 0.38; p < 0.001). fT3 was also inversely associated with hemoglobin (r = –0.41; p < 0.001), systolic pressure (r = –0.28; p < 0.001) and the plasma concentration of the endogenous inhibitor of NO synthase, asymmetric dimethylarginine (ADMA; r = –0.18; p = 0.007). However, adjustment for ADMA markedly attenuated the fT3-FMD link, a phenomenon suggesting that raised plasma ADMA, possibly driven by low fT3, at least in part mediates the adverse effects of low T3 on endothelial function in CKD. Conclusions: Low T3 in patients with moderate-to-severe CKD is a marker of endothelial dysfunction. This study sets a solid rationale for designing specific intervention studies aimed at clarifying the nature (causal or not causal) of the endothelial function-T3 link in CKD.

© 2010 S. Karger AG, Basel


References

  1. Kaptein EM: Thyroid hormone metabolism and thyroid diseases in chronic renal failure. Endocr Rev 1996;17:45–63.
  2. Chopra IJ, Chopra U, Smith SR, Reza M, Solomon DH: Reciprocal changes in serum concentrations of 3,3′,5-triiodothyronine (T3) in systemic illnesses. J Clin Endocrinol Metab 1975;41:1043–1049.
  3. Iervasi G, Pingitore A, Landi P, Raciti M, Ripoli A, Scarlattini M, L’Abbate A, Donato L: Low-T3 syndrome: a strong prognostic predictor of death in patients with heart disease. Circulation 2003;107:708–713.
  4. Kaptein EM, Weiner JM, Robinson WJ, Wheeler WS, Nicoloff JT: Relationship of altered thyroid hormone indices to survival in nonthyroidal illnesses. Clin Endocrinol (Oxf) 1982;16:565–574.
  5. Scoscia E, Baglioni S, Eslami A, Iervasi G, Monti S, Todisco T: Low triiodothyronine (T3) state: a predictor of outcome in respiratory failure? Results of a clinical pilot study. Eur J Endocrinol 2004;151:557–560.
  6. Rink C, Siersleben U, Haerting J, Mende T, Nilius R: Development of the low-T3 syndrome and prognosis assessment in patients with liver cirrhosis. Gastroenterol J 1991;51:138–141.
  7. Zoccali C, Tripepi G, Cutrupi S, Pizzini P, Mallamaci F: Low triiodothyronine: a new facet of inflammation in end-stage renal disease. J Am Soc Nephrol 2005;16:2789–2795.
  8. Zoccali C, Mallamaci F, Tripepi G, Cutrupi S, Pizzini P: Low triiodothyronine and survival in end-stage renal disease. Kidney Int 2006;70:523–528.
  9. Carrero JJ, Qureshi AR, Axelsson J, Yilmaz MI, Rehnmark S, Witt MR, Bárány P, Heimbürger O, Suliman ME, Alvestrand A, Lindholm B, Stenvinkel P: Clinical and biochemical implications of low thyroid hormone levels (total and free forms) in euthyroid patients with chronic kidney disease. J Intern Med 2007;262:690–701.
  10. Zoccali C, Benedetto F, Mallamaci F, Tripepi G, Cutrupi S, Pizzini P, Malatino LS, Bonanno G, Seminara G: Low triiodothyronine and cardiomyopathy in patients with end-stage renal disease. J Hypertens 2006;24:2039–2046.
  11. Song SH, Kwak IS, Lee DW, Kang YH, Seong EY, Park JS: The prevalence of low triiodothyronine according to the stage of chronic kidney disease in subjects with a normal thyroid-stimulating hormone. Nephrol Dial Transplant 2009;24:1534–1538.
  12. Napoli R, Guardasole V, Angelini V, Zarra E, Terracciano D, D’Anna C, Matarazzo M, Oliviero U, Macchia V, Saccà L: Acute effects of triiodothyronine on endothelial function in human subjects. J Clin Endocrinol Metab 2007;92:250–254.
  13. Taddei S, Caraccio N, Virdis A, Dardano A, Versari D, Ghiadoni L, Salvetti A, Ferrannini E, Monzani F: Impaired endothelium-dependent vasodilatation in subclinical hypothyroidism: beneficial effect of levothyroxine therapy. J Clin Endocrinol Metab 2003;88:3731–3737.
  14. Napoli R, Guardasole V, Zarra E, D’Anna C, de Sena A, Lupoli GA, Oliviero U, Matarazzo M, Lupoli G, Saccà L: Impaired endothelial- and nonendothelial-mediated vasodilation in patients with acute or chronic hypothyroidism. Clin Endocrinol (Oxf) 2010;72:107–111.
  15. Yilmaz MI, Saglam M, Caglar K, Cakir E, Sonmez A, Ozgurtas T, Aydin A, Eyileten T, Ozcan O, Acikel C, Tasar M, Genctoy G, Erbil K, Vural A, Zoccali C: The determinants of endothelial dysfunction in CKD: oxidative stress and asymmetric dimethylarginine. Am J Kidney Dis 2006;47:42–50.
  16. Yilmaz MI, Sonmez A, Saglam M, Gulec M, Kilic S, Eyileten T, Caglar K, Oguz Y, Vural A, Yenicesu M, Zoccali C: Hemoglobin is inversely related to flow-mediated dilatation in chronic kidney disease. Kidney Int 2009;75:1316–1321.
  17. Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D: A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med 1999;130:461–470.
  18. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC: Homeostasis model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985;28:412–419.
  19. Celermajer DS, Sørensen KE, Gooch VM, Spiegelhalter DJ, Miller OI, Sullivan ID, Lloyd JK, Deanfield JE: Non-invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis. Lancet 1992;340:1111–1115.
  20. Corretti MC, Anderson TJ, Benjamin EJ, Celermajer D, Charbonneau F, Creager MA, Deanfield J, Drexler H, Gerhard-Herman M, Herrington D, Vallance P, Vita J, Vogel R: Guidelines for the ultrasound assessment of endothelial-dependent flow-mediated vasodilation of the brachial artery: a report of the International Brachial Artery Reactivity Task Force. J Am Coll Cardiol 2002;39:257–265.
  21. Kleinbaum DG, Kupper LL, Muller KE, Nizam A: Applied Regression Analysis and Other Multivariable Methods. Pacific Grove, Duxbury, 1998, pp 388–390.
  22. Zoccali C: The endothelium as a target in renal diseases. J Nephrol 2007;20(suppl 12): S39–S44.
    External Resources
  23. Zoccali C: Traditional and emerging cardiovascular and renal risk factors: an epidemiologic perspective. Kidney Int 2006;70:26–33.
  24. Ravani P, Tripepi G, Malberti F, Testa S, Mallamaci F, Zoccali C: Asymmetrical dimethylarginine predicts progression to dialysis and death in patients with chronic kidney disease: a competing risks modeling approach. J Am Soc Nephrol 2005;16:2449–2455.
  25. Zoccali C, Maio R, Tripepi G, Mallamaci F, Perticone F: Inflammation as a mediator of the link between mild to moderate renal insufficiency and endothelial dysfunction in essential hypertension. J Am Soc Nephrol 2006;17(4 suppl 2):S64–S68.
    External Resources
  26. Caglar K, Yilmaz MI, Saglam M, Cakir E, Kilic S, Sonmez A, Eyileten T, Yenicesu M, Oguz Y, Tasar M, Vural A, Ikizler TA, Stenvinkel P, Lindholm B: Serum fetuin-A concentration and endothelial dysfunction in chronic kidney disease. Nephron Clin Pract 2008;108:c233–c240.
  27. Arikan E, Karadag CH, Guldiken S: Asymmetric dimethylarginine levels in thyroid diseases. J Endocrinol Invest 2007;30:186–191.
  28. Pingitore A, Galli E, Barison A, Iervasi A, Scarlattini M, Nucci D, L’Abbate A, Mariotti R, Iervasi G: Acute effects of triiodothyronine (T3) replacement therapy in patients with chronic heart failure and low-T3 syndrome: a randomized, placebo-controlled study. J Clin Endocrinol Metab 2008;93:1351–1358.
  29. Bocanera LV, Krawiec L, Silberschmidt D, Pignataro O, Juvenal GJ, Pregliasco LB, Pisarev MA: Role of cyclic 3′5′ guanosine monophosphate and nitric oxide in the regulation of iodide uptake in calf thyroid cells. J Endocrinol 1997;155:451–457.

Article / Publication Details

First-Page Preview
Abstract of Original Report: Laboratory Investigation

Received: September 29, 2010
Accepted: November 05, 2010
Published online: December 09, 2010
Issue release date: January 2011

Number of Print Pages: 8
Number of Figures: 3
Number of Tables: 2

ISSN: 0250-8095 (Print)
eISSN: 1421-9670 (Online)

For additional information: https://www.karger.com/AJN


Copyright / Drug Dosage / Disclaimer

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.