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投稿时间:2023-04-28 网络发布日期:2023-12-20
投稿时间:2023-04-28 网络发布日期:2023-12-20
中文摘要: 目的 探讨低三碘甲状腺原氨酸(T3)综合征(LT3S)在2型糖尿病(T2DM)患者中的发生率及其与糖尿病肾病(DN)的相关性。
方法回顾性选取2020年1月至2022年2月在蚌埠市中心医院住院的T2DM患者185例,根据尿微量白蛋白与尿肌酐比值(ACR)将其分为三组:正常白蛋白尿组(A组,84例,ACR<30 mg/g)、微量白蛋白尿组(B组,54例,30 mg/g≤ACR<300 mg/g)和大量白蛋白尿组(C组,47例,ACR≥300 mg/g)。检测静脉血血脂、糖化血红蛋白(HbA1c)、肝肾功能和甲状腺激素水平,根据慢性肾脏病流行病学协作研究(CKDEPI)公式由血肌酐计算估算肾小球率过滤(eGFR),结合反T3(rT3)数据明确LT3S的诊断,分析甲状腺功能与ACR的相关性。
结果 随ACR 水平(A组→B组→C组)的增高,患者血浆T3、游离T3(FT3)水平逐步降低(F=9.019、18.702,P<0.01),LT3S的发生率在A组(0)、B组(3.70%)、C组(14.89%)逐步升高(χ2=14.666,P<0.01)。三组分别在年龄、吸烟史、糖尿病病程、收缩压、白蛋白、尿素氮、eGFR、FT3、T3差异有统计学意义(P<0.05)。多元线性回归分析结果显示,FT3与ACR呈负相关(β=-0.330,P<0.05), 收缩压与ACR呈正相关(β=0.203,P<0.05)。
结论 T2DM患者LT3S的发生与ACR水平有关,检测甲状腺激素水平有助于DN患者的早期诊断和病情评估。
中文关键词: 低三碘甲状腺原氨酸综合征 非甲状腺疾病综合征 2型糖尿病 糖尿病肾病 尿微量白蛋白与尿肌酐比值 收缩压 血压
Abstract:Objective To investigate the incidence of low triiodothyronine (T3) syndrome in type 2 diabetes mellitus (T2DM) and its correlation with the development of diabetic nephropathy (DN).
Methods A total of 185 patients with T2DM hospitalized in Central Hospital of Bengbu from January 2020 to February 2022 were retrospectively selected and divided into three groups according to urinary albumin to creatinine ratio (ACR) : normoalbuminuria group (group A ,n=84, ACR<30 mg/g), microalbuminuria group (group B, n=54, 30 mg/g≤ACR<300 mg/g) and macroalbuminuria group (group C,n=47, ACR≥300 mg/g). Venous blood lipid, glycosylated hemoglobin (HbA1c), and liver, kidney and thyroid function levels were measured to analyze the correlation between thyroid function and ACR. The estimated glomerular rate filtration (eGFR) was calculated by serum creatinine according to the CKD-EPI formula. The diagnosis of low T3 syndrome was confirmed by combining the inverse T3(rT3) level,
Results With the increase of ACR level (group A → group B → group C), plasma T3 and free T3 (FT3) levels were gradually decreased (F=9.019, 18.702, P<0.01), and the incidence of low T3 syndrome was gradually increased in group A (0), group B (3.70%) and group C (14.89%) (χ2=14.666, P<0.01). There were statistically significant differences in age, smoking history, diabetes course, systolic blood pressure, albumin, blood urea nitrogen, eGFR, FT3 and T3 among the three groups (P<0.05). Multiple linear regression analysis showed that FT3 was negatively correlated with ACR (β=-0.330, P<0.05), systolic blood pressure was positively correlated with ACR (β=0.203, P<0.05).
Conclusion The occurrence of low T3 syndrome in T2DM patients is related to ACR level. Early detection of thyroid hormone level is helpful for the early diagnosis and disease evaluation of T2DM patients with DN.
keywords: Low triiodothyronine syndrome Non-thyroidal illness syndrome Type 2 diabetes mellitus Diabetic nephropathy Urinary albumin to creatinine ratio Systolic blood pressure Blood pressure
文章编号: 中图分类号:R581.2 R587.2 文献标志码:A
基金项目:蚌埠市科技创新指导类项目(20200326)
Author Name | Affiliation |
LI Xiaonan, CAO Lei | Department of Nephrology, Central Hospital of Bengbu, the Third?People's Hospital of Bengbu, Bengbu Medical College, Bengbu, Anhui 233000, China |
引用文本:
李晓楠,曹磊.2型糖尿病合并低三碘甲状腺原氨酸综合征的发病率及相关因素[J].中国临床研究,2023,36(12):1826-1830.
李晓楠,曹磊.2型糖尿病合并低三碘甲状腺原氨酸综合征的发病率及相关因素[J].中国临床研究,2023,36(12):1826-1830.