The Cardiovascular Disease Risks of Nonthyroidal Illness Syndrome and Inflammatory Responses on Patients with Chronic Kidney Disease: From the Association to Clinical Prognosis

Summary Background Previous data have suggested the potential risk of low serum‐free triiodothyronine ( FT 3) on the cardiovascular disease ( CVD ) events in patients with end‐stage renal disease ( ESRD ). However, the roles of FT 3 and interleukin‐6 ( IL ‐6) in the developing of CVD events in patients with chronic kidney disease ( CKD ) have not been investigated. Patients and 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 FT 3: group A, 83 patients with FT 3 <4.0 pmol/L, and group B, 93 patients with FT 3 >4.0 pmol/L. Results Serum FT 3 ( 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 FT 3 had significantly higher CVD incidence than those with FT 3 >4.0 pmol/L ( HR 1.81, P  =   0.038), when extensive demographics, comorbidities and laboratory adjustments were made. Conclusions Serum levels of FT 3 and IL ‐6 were associated with the LVMI and previous CVD events; lower FT 3 and higher IL ‐6 were strong predictors of subsequent CVD events in patients with CKD .