住院2型糖尿病患者甲状腺激素与慢性肾脏病检出率的关系

doi:10.3969/j.issn.1001-9057.2019.12.009

摘要/Abstract

摘要： 目的探讨住院2型糖尿病（T2DM）患者甲状腺激素与慢性肾脏病（CKD）检出率的关系。方法纳入于我科住院的T2DM患者1118例，根据是否合并CKD将其分为CKD组205例和非CKD（NCKD）组913例,收集两组患者的临床资料并进行比较。采用多因素logistic回归分析评估与CKD相关的危险因素。结果 T2DM合并高血压患者中CKD检出率高于单纯T2DM患者（P<0.001）。CKD组患者年龄、高血压病程、T2DM病程、收缩压、舒张压、促甲状腺激素(TSH)水平均高于NCKD组，空腹血糖（FPG）、糖化血红蛋白(HbA1c)、总三碘甲腺原氨酸(TT₃)、总甲状腺素(TT₄)、游离三碘甲腺原氨酸(FT₃)及游离甲状腺素（FT₄)水平均低于NCKD组（P<0.05）。多因素logistic回归分析结果显示，FT₃、T2DM病程、FPG、低密度脂蛋白胆固醇(LDL-C)、收缩压与蛋白尿伴估算的肾小球滤过率(eGFR)下降独立相关；FT₃、性别及收缩压与蛋白尿独立相关；TT₄、FT₃、T2DM病程、年龄、LDL-C、舒张压与eGFR下降独立相关；FT₃为蛋白尿、eGFR下降及蛋白尿伴eGFR下降的独立危险因素（P均<0.05）。结论伴CKD的T2DM患者甲状腺激素水平与单纯T2DM患者不同，其中FT₃是蛋白尿、eGFR下降及蛋白尿伴eGFR下降的独立危险因素，可能影响CKD的检出率。

关键词: 糖尿病; 慢性肾脏病; 检出率; 甲状腺激素

Abstract: Objective〓〖WT5”BZ〗To investigate the relationship between thyroid hormones and the detection〖JP〗 rate of chronic kidney disease(CKD) in hospitalized patients with type 2 diabetes mellitus(T2DM).〖WT5”HZ〗Methods〓〖WT5”BZ〗A total of 1118 T2DM patients were included in our department.All patients were divided into CKD group and nonchronic kidney disease(NCKD) group according to whether accompanied with CKD.General and clinical data of the two groups were collected and compared.Multivariate logistic regression analysis was used to study the risk factors related to CKD.〖WT5”HZ〗Results〓〖WT5”BZ〗The detection rate of CKD in T2DM+hypertension(HP) patients was higher than that in T2DM patients（P<0.001）.The age,course of HP,course of T2DM,systolic blood pressure,diastolic blood pressure and the level of thyrotrophin(TSH) in CKD group were higher than those in NCKD group，the level of fasting glucose(FPG),glycosylated hemoglobin(HbA1c),triiodinated thyroxine (TT3),free thyroxine(TT4),free triiodinated thyroxine (FT3) and free thyroxine (FT4) were lower than those in NCKD group（P<0.05）.Multivariate logistic regression analysis showed that the level of FT3,course of T2DM,FPG,lowdensity lipoprotein（LDLC）,systolic blood pressure were independently related to proteinuria accompanied estimated glomerular rate(eGFR) decrease，the level of FT3,gender and systolic blood pressure were independently related to proteinuria，the level of TT4，FT3，the course of T2DM,age,LDLC and diastolic blood pressure were independently related to eGFR decrease，FT3 was an independent risk factor for proteinuria,eGFR decrease and proteinuria with eGFR decrease.〖WT5”HZ〗Conclusion〓〖WT5”BZ〗The levels of thyroid hormone in T2DM patients with CKD are different from those in T2DM patients.FT3 is an independent risk factor for proteinuria,eGFR decrease,and proteinuria with eGFR decrease,it may affect the detection rate of CKD.

Key words: Diabetes mellitus; Chronic kidney disease; Detection rate; Thyroid hormone

雷永富, 李敏. 住院2型糖尿病患者甲状腺激素与慢性肾脏病检出率的关系[J]. 临床内科杂志, 2019, 36(12): 819-822.

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住院2型糖尿病患者甲状腺激素与慢性肾脏病检出率的关系

Relationship between the thyroid hormone and the detection rate of chronic kidney disease in hospitalized patients with type 2 diabetes mellitus

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