摘要
目的探讨甲状腺功能与2型糖尿病肾病患者临床分期的关联性。方法本研究为回顾性病例对照研究设计,选取2021年1—2月在东莞市中医院内分泌科和体检科就诊的患者作为研究对象。从内分泌科选择25例单纯糖尿病患者(单纯糖尿病组)和50例糖尿病肾病患者(微量白蛋白尿组和大量白蛋白尿组,每组各25例);从体检科选择与糖尿病患者的性别和年龄相匹配的25例健康志愿者作为对照组。测量研究对象的身高、体重,并收集研究对象的血肌酐、随机微量白蛋白、24 h微量白蛋白、尿肌酐、胱抑素C、促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT_(3))、游离甲状腺素(FT_(4))、计算尿白蛋白肌酐比(UACR)、尿清蛋白排泄率(UAER)、估算的肾小球滤过率(eGFR)。结果与单纯糖尿病组相比,糖尿病肾病组TSH水平更高,FT_(3)水平更低(均P<0.05)。Spearman相关分析显示在糖尿病肾病组,TSH与血清肌酐、尿肌酐、胱抑素C、UACR和UAER呈正相关(均P<0.05),与eGFR呈负相关(P<0.001);FT_(3)和FT_(4)与血肌酐、UACR和eGFR均呈正相关(均P<0.05),差异有统计学意义。结论在糖尿病肾病组中可观察到高水平的TSH和低水平的FT_(3)。未来需要前瞻性研究来证实亚临床甲状腺功能减退症与糖尿病肾病之间的关联。
Objective To investigate the correlation between thyroid function and clinical staging of the patients with type II diabetic nephropathy(DN).Methods This study was designed as a retrospective case-control study.The patients who were treated at Department of Endocrinology and Department of Health Checkup of Dongguan Traditional Chinese Medicine Hospital from January 2021 to February 2021 were selected as the subjects of research.25 patients with simple diabetes mellitus(the SDM group)and 50 patients with DN(the microalbumin uria group and the massive albuminuria group,each with 25 patients)were selected from Department of Endocrinology.25 healthy volunteers matched with the patients with DM in gender and age were selected from Department of Health Checkup as the control group.The height and weight of the subjects were measured,and their serum creatinine,random microalbumin,24-h microalbumin,urine creatinine,cystatin C,thyroid stimulating hormone(TSH),free triiodothyronine(FT_(3)),free thyroxine(FT_(4))were collected,and urine albumin-tocreatinine ratio(UACR),urinary albumin excretion rate(UAER)and estimated glomerular filtration rate(eGFR)were calculated.Results Compared with the SDM group,the DN groups had higher TSH levels and lower FT_(3) levels(both,P<0.05).Spearman correlation analysis showed that in the DN groups TSH was positively correlated with serum creatinine,urine creatinine,cystatin C,UACR and UAER(both,P<0.05)and negatively correlated with eGFR(P<0.001);FT_(3) and FT_(4) were positively correlated with serum creatinine,UCAR and eGFR(both,P<0.05),and the differences were statistically significant.Conclusion High level TSH and low level FT_(3) can be seen in the DN groups.In the future,prospective studies will be needed to confirm the correlation between subclinical hypothyroidism and DN.
作者
李汉秋
冯奕习
陈见辉
叶永龙
LI Hanqiu;FENG Yixi;CHEN Jianhui;YE Yonglong(Department of Clinical Laboratory,Dongguan Traditional Chinese Medicine Hospital,Guangdong,Dongguan 523000,China)
出处
《中国医药科学》
2021年第23期151-154,185,共5页
China Medicine And Pharmacy
关键词
糖尿病肾病
促甲状腺激素
病例对照研究
估算的肾小球滤过率
Diabetic nephropathy
Thyroid stimulating hormone
Case-control study
Estimated glomerular filtration rate
