摘要
目的 探讨原发性甲状腺功能减退(primary hypothyroidism)合并2型糖尿病肾病(type 2 diabetic kidney disease, DKD)患者血清甲状腺激素和促甲状腺激素与尿白蛋白之间的相关性关系。方法 选取2017年12月1日至2022年12月1日在南阳南石医院内分泌科收治的原发性甲状腺功能减退合并糖尿病肾病的患者143例。根据尿蛋白水平,分为正常白蛋白尿(normal albuminuria, NA)组、微量白蛋白尿(microalbuminuria, MA)组和大量白蛋白尿(overt albuminuria, OA)组,比较三组间一般临床数据,对影响原发性甲状腺功能减退患者合并2型糖尿病肾病患者尿白蛋白的相关因素进行logistic多因素回归分析,并用Pearson相关性分析明确血清甲状腺激素和促甲状腺激素与尿白蛋白间的相关性。结果 三组间三碘甲状腺原氨酸(three iodine thyroid, FT3)、四碘甲状腺原氨酸(four iodine thyroid, FT4)与促甲状腺激素(thyroid stimulating hormone, TSH)水平均存在显著差异(P均<0.05),表现为尿白蛋白水平越高,FT3和FT4水平越低,而TSH水平越高。TSH、FT3和FT4为引起原发性甲状腺功能减退合并糖尿病肾病患者尿白蛋白水平升高的独立危险因素(OR=2.372、2.180、2.438,P<0.05),且血清FT3和FT4水平(r=-0.852、-0.942,P均<0.05)与尿白蛋白水平呈显著负相关,血清TSH与尿白蛋白水平呈显著正相关(r=0.793,P=0.042)。结论 原发性甲状腺功能减退合并糖尿病肾病患者的血清FT3、FT4和TSH水平与尿白蛋白水平关系密切,血清FT3和FT4水平过低、TSH水平过高是尿白蛋白升高的独立危险因素。
Objective To demonstrate the correlation between serum thyroid hormone,thyroid-stimulating hormone(TSH)and albuminuria in patients with primary hypothyroidism combined with Type 2 diabetic kidney disease(DKD).Methods A total of 143 patients with primary hypothyroidism combined DKD admitted to the Department of Endocrinology from December 1,2017 to December 1,2022 were enrolled.According to the level of urine protein,they were divided into normal albuminuria(NA)group,microalbuminuria(MA)group and overt albuminuria(OA)group.The general clinical data were compared among the three groups,and logistic multivariate regression analysis was performed to determine the factors affecting albuminuria in patients with primary hypothyroidism combined with DKD.Pearson correlation analysis was used to analyze the correlation relationship between serum thyroid hormone,TSH and urine albumin.Results The levels of FT3,FT4 and TSH were significantly different among the NA,MA and OA groups.Furthermore,the higher urine albumin level,the lower FT3 and FT4,levels,while higher TSH level.TSH,FT3,and FT4 were independent risk factors for increased albuminuria in patients with primary hypothyroidism combined with DKD(OR=2. 372, 2. 180, 2. 438, P <0. 05), and serum FT3 and FT4 levels(r = -0. 852, -0. 942, P <0. 05) was significantlynegatively correlated with urinary albumin levels, and serum TSH was significantly positively correlated with urinary albumin levels(r =0. 793, P =0. 042). Conclusion Serum FT3, FT4 and TSH levels in patients with primary hypothyroidism combined with DKD are closely related to albuminuria levels, and serum FT3 and FT4 levels and high TSH levels are independent risk factors for increased albuminuria.
作者
彭召龙
孙可可
PENG Zhao-long;SUN Ke-ke(Department of Clinical Laboratory,Nanyang Nanshi Hospital,Nanyang,Henan 473000,China)
出处
《医药论坛杂志》
2024年第21期2339-2343,共5页
Journal of Medical Forum
