prevalence of malnutrition-inflammation complex syndrome and its correlation with thyroid hormones in chronic haemodialysis patients

Abstract

Introduction: Low levels of thyroid hormones, total triiodothyronine (T3) and free triiodothyronine (FT3) in haemodialysis patients are a marker of malnutrition and inflammation and are predictors of mortality. The aim of this study was to determine the prevalence of malnutrition-inflammation complex syndrome in haemodialysis and its relationship with the thyroid hormones thyrotropin, T3, FT3 and free thyroxine (FT4), as well as to evaluate the prevalence of low FT3 syndrome and its correlation with nutritional and inflammatory markers. Materials and methods: Cross-sectional, analytical and comparative study that enrolled 128 haemodialysis patients: 50.8% females; mean age 45.05 ± 17.01 years; mean time on haemodialysis 45.4 ± 38.8 months; 29.7% diabetics; 79.7% with hypertension. Serum thyroidhormones thyrotropin, T3, FT3 and FT4 concentrations were measured and Malnutrition-Inflammation Score (MIS) was applied to diagnostic. Results: Mean thyroid hormone values were: thyroid hormones thyrotropin 2.48 ± 1.8 mIU/ml (range: 0.015–9.5), T3 1.18 ± 0.39 ng/ml (range 0.67–2.64), FT3 5.21 ± 0.96 pmol/l (range: 3.47–9.75); FT4 1.35 ± 0.4 ng/ml (range: 0.52–2.57). Malnutrition-inflammation complex syndrome prevalence was 53.9%; 11.7% presented low FT3 levels. Serum T3 and FT3 concentrations inversely correlated with Malnutrition-Inflammation Score (MIS), while FT4 correlated positively with Malnutrition-Inflammation Score. In the linear regression analysis, low FT3 was associated with IL-6 (β = 0.265, p = .031), C-reactive protein (CRP) (β = −0.313, p = .018) and albumin (β = 0.276, p = .002). Conclusion: Low T3 and FT3 levels are correlated with malnutrition and inflammation parameters. Malnutrition-inflammation complex syndrome can affect serum concentrations of thyroid hormones.