临床内科杂志 ›› 2019, Vol. 36 ›› Issue (10): 685-688.doi: 10.3969/j.issn.1001-9057.2019.10.012

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Graves病患者血清磷水平与甲状腺功能的相关分析

  

  • 出版日期:2019-10-15 发布日期:2019-10-30
  • 基金资助:
    上海市自然科学基金资助项目(18ZR1429900)

Correlation analysis on serum phosphorus and thyroid function in Graves’ disease patients

  • Online:2019-10-15 Published:2019-10-30

摘要:

目的 探讨Graves病患者血清磷水平与甲状腺功能的相关性。方法 纳入初次发病或复发但未使用药物治疗的Graves病患者348例,收集电解质、肝肾功能、甲状腺功能、促甲状腺素受体抗体(TRAb)、摄碘率等临床资料。以血清磷正常参考值范围上限1.45mmol/L为切点数值将其分为高磷组和正常磷组,采用非参数检验比较两组间各参数的差异,logistic回归分析评估可能影响血清磷水平的相关因素。结果 348例患者中,144例(41.38%)出现高磷血症。高磷组患者年龄和BMI均明显低于正常磷组(P<0.05),而三碘甲状腺原氨酸(T3)、游离三碘甲状腺原氨酸(FT3)、TRAb、3小时摄碘率(3h RAIU)、24小时摄碘率(24h RAIU)和血清钙(Ca)均明显高于正常磷组(P <0.05)。Graves病患者的年龄(r=-0.158)和BMI(r =-0.146)与血清磷水平呈负相关,T3r=0.188)、FT3r=0.134)、3h RAIU(r=0.159)、24h RAIU(r=0.186)与血清磷水平呈正相关(P<0.05)。Logistic回归分析结果示,年龄(OR=0.982,95%CI  0.966~0.998,P=0.032)、性别(OR=0.555,95%CI 0.346~0.891,P=0.015)、FT3OR=1.030,95%CI 1.007~1.053,P=0.011)是Graves病患者血清磷水平的影响因素。结论 Graves病患者存在磷代谢异常,年龄偏低、女性、FT3水平升高患者更易出现高磷血症。

关键词: Graves病;血清磷代谢; 甲状腺激素

Abstract: Objective〓〖WT5”BZ〗To explore the correlation between serum phosphorus and thyroid function in Graves’disease patients.〖WT5”HZ〗Methods〓〖WT5”BZ〗A total of 348 newonset or recurrent Graves’ disease patients without medication were enrolled in our study,and their clinical data including electrolyte,liver and kidney function,thyroid function,thyrotropin receptor antibody(TRAb) and iodine uptake rate were collected.According to the normal high cutoff value for serum phosphorus(1.45mmol/L),the patients were divided into hyperphosphatemic group and normophosphatemic group.Nonparametric test was used to analyze the different parameters between the two groups,and logistic regression analysis was used to analyze the related factors that might affect serum phosphorus level.〖WT5”HZ〗Results〓〖WT5”BZ〗The incidence of hyperphosphatemia was 41.38%(144/348).Patients in hyperphosphatemic group showed that age and BMI were lower than those in normophosphatemic group(P<0.05),while triiodothyronine(T3),free triiodothyronine(FT3)TRAb,3h radioactive iodine uptake(3h RAIU),24h radioactive iodine uptake(24h RAIU) and calcium(Ca) were higher than those in normophosphatemic group(P<0.05).BMI(r=-0.158),T3(r=-0.146),FT3(r=0.188),3h RAIU(r=0.159) and 24h RAIU(r=0.186) are correlated with serum phosphorus〖JP3〗(P<0.05).Logistic regression analysis indicated that age(OR=0.982,95%CI 0.966~0.998,P=0.032),〖JP〗gender(OR=0.555,95%CI 0.346~0.891,P=0.015) and FT3(OR=0.555,95%CI 0.346~0.891,P=0.015) were the relative factors for hyperphosphatemia..〖WT5”HZ〗Conclusion〓〖WT5”BZ〗There is abnormal phosphorus metabolism in Graves’disease patients.Patients of younger age,female and elevated FT3 are more likely to suffer hyperphosphatemia.

Key words: Graves’disease; Phosphorus metabolism; Thyroid hormone