2型糖尿病患者中亚临床甲状腺功能减退症与慢性肾脏病的相关性分析被引量：14

Correlation of subclinical hypothyroidism with chronic kidney disease in patients with type 2 diabetes

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摘要目的探讨2型糖尿病患者中亚临床甲状腺功能减退症（SCH）与慢性肾脏病（CKD）之间的关系. 方法回顾性分析重庆医科大学附属第二医院内分泌科2012-01～2013-01间收治的991例2型糖尿病患者的病例资料.以促甲状腺激素（TSH）＞5 mU/L（正常参考值为0.35-5 mU/L）并且游离三碘甲状腺原氨酸（FT3）与游离甲状腺素（FT4）在正常范围内定义为亚临床甲状腺功能减退症.比较亚临床甲状腺功能减退组与甲状腺功能正常组之间慢性肾脏病的患病率,行多因素回归分析来评估亚临床甲状腺功能减退症与慢性肾脏病的相关性. 结果 991例2型糖尿病患者中,有126例（12.7％）患者存在亚临床甲减.亚临床甲减组与甲状腺功能正常组之间慢性肾脏病的患病率无统计学差异（P＞0.05）;在亚组分析中,严重的亚临床甲减组（TSH≥10 mU/L）中糖尿病肾病的患病率显著高于TSH在0.35-9.99 mU/L之间的患者（P＜0.05）.多因素logistic回归分析结果提示在2型糖尿病患者中,严重亚临床甲减可增加慢性肾脏病的患病风险. 结论在2型糖尿病患者中,慢性肾脏病的患病风险在严重亚临床甲减人群中高于甲状腺功能正常及轻微的亚临床甲减人群. Objective To explore the relationship between subclinical hypothyroidism and chronic kidney disease in patients with type 2 diabetes.Methods The clinical data were respectively analyzed in 991 patients with type 2 diabetes at admission from Second Affiliated Hospital of Chongqing Medical University from January 2012 to January 2013.Patients with normal levels of free triiodothyronine and free thyroxine,but an increased level of thyroid stimulating hormone （TSH）（＞ 5.00 mU/L）,were diagnosed with subclinical hypothyroidism.The prevalence of chronic kidney disease was observed and compared between euthyroidism and subclinical hypothyroidism.Logistic regression analysis was used to analyze the relationship between subclinical hypothyroidism and chronic kidney disease.Results Of 991 patients,126 （12.7％）had subclinical hypothyroidism.Patients with subclinical hypothyroidism had no significant difference from euthyroid patients with regard to prevalence of chronic kidney disease （P ＞ 0.05）.The prevalence of chronic kidney disease was significantly higher in patients with TSH ≥ 10 mU/L than in patients with lower TSH of 0.35-0.99 mU/L（P ＜ 0.05）.The logistic regression analysis showed that the severe SCH was a high risk factor for CKD（OR 1.842,95％ CI 1.120-3.029,P =0.016）.Conclusion In type 2 diabetic patients,the incidence of chronic kidney disease is higher in patients with severe subclinical hypothyroidism than those in mild subclinical hypothyroidism and euthyroidism.

作者贾方王小娟田晶杨刚毅龙敏刘东方

机构地区重庆医科大学附属第二医院内分泌科西安交通大学医学部公共卫生学院

出处《山西医科大学学报》 CAS 2014年第11期1028-1031,共4页 Journal of Shanxi Medical University

基金国家自然科学基金资助项目(81370467)

关键词 2型糖尿病亚临床甲状腺功能减退症慢性肾脏病 type 2 diabetes subclinical hypothyroidism chronic kidney disease

分类号 R587.1 [医药卫生—内分泌]

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