尿微量白蛋白排泄率与血清促甲状腺激素相关性研究  

The correlation of thyrotropin and urine albumin creatine ratio

作　　者：刘爱华[1] 赖亚新[1] 姜凤伟[1] 王蓓蓓[1] 王佳妮[1] 陈彦彦[1] 李祉丹[1] 单玲[1] 史良凤[1] 李宁娜[1] 于嘉澍[1] 鲁丽[1] 白雪[1] 王森[1] 单忠艳[1] 滕卫平[1] 

机构地区：[1]中国医科大学附属第一医院内分泌科辽宁省内分泌疾病重点实验室,沈阳110001

出　　处：《中国实用内科杂志》2012年第6期461-463,473,共4页Chinese Journal of Practical Internal Medicine

摘　　要：目的探讨尿微量白蛋白排泄率(ACR)与血清促甲状腺激素(TSH)的关系。方法 2007年10月对沈阳市大东区居民进行分层抽样调查共收集1523人,详细填写流行病学调查表,测量血压、身高、体重及腰围(WHR),采集血样测定TSH、甲状腺氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TgAb)、空腹血糖(FPG)、糖负荷后30 min血糖(OGGT 30minPG)、2 h血糖(OGTT 2hPG)、空腹胰岛素浓度(FINS)、三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C),采集空腹尿液检测尿微量白蛋白(MAU)及尿肌酐,计算尿微量白蛋白与尿肌酐比值。结果 MAU的发生率为11.8%,MAU的发生率随年龄的增长而增加(P<0.01)。MAU组较非MAU组的腰围、体重指数、收缩压、舒张压、心率、空腹血糖、糖负荷后30min血糖、糖负荷后2h血糖、TG、胰岛素抵抗指数均有明显升高(P<0.05);WHR、FINS、TC、HDL-C、LDL-C差异无统计学意义(P>0.05);TSH、亚临床甲减及亚临床甲亢的患病率差异亦无统计学意义(P>0.05);Logistic分析提示,高血压、高血糖是ACR的独立危险因素(OR值分别为1.868和1.469,P均<0.05)。结论 ACR与血清TSH未见相关性,高血糖、高血压是发生ACR的独立危险因素。Objective To explore the relationship between urine albumin creatine ratio （ACR） and serum thyrotropin （TSH）. Methods In October 2007, a total of 1534 adult inhabitants in Dadong district of Shenyang were asked to fulfill the questionnaires and measure the blood pressure, height, weight and waist. The vein blood was drawn to measure thyrotropin （ TSH ）, thyroid peroxidase antibody （ TPOAb）, Thyroglobulin antibody （ TGAb）, fasting plasma glucose （ FPG）, OG- TT 30minPG, OGTF 2hPG,fasting insulin, triglyceride （ TG ）, total cholestoral （ TC ） , high density lipoprotein cholesterol （HDL-C） and low density lipoprotein cholesterol （LDL-C）. Fasting urine samples were collected for measurement of creatinine and microalbumin, and the microalbumin/creatinine ratio （ACR） was calculated. Results The prevalence of microalbuminuria was 11.8% and was increasing with age （ P 〈 0. 01 ）. Compared with subjects with normal microalbumin, the waist, BMI, systolic pressure, diastolic pressure, heart rate, FPG, OGTT 30minPG, OGTT 2hPG, serum TG, and homeostasis model assessment insulin resistance （HOMA-IR） were all significantly increased in subjects with microalbuminuria （ P 〈 0. 05 ）. However serum TSH, the prevalence of subclinical hypothyroidism and hyperthyroidism was no statistical difference between the two groups （ P 〉 0. 05 ）. Hyperglycemia and hypertension was independently associated with the prevalence of microalbuminuria （ hypertension OR = 1. 868, P 〈 0. 01 ; hyperglycemia OR = 1. 469, P 〈 0. 05 ）. Conclusion ACR was not related with serum TSH ,while the hyperglycemia and hypertension was independently associated with the prevalence of microalbuminuria.

关 键 词：尿微量白蛋白排泄率 微量白蛋白尿 促甲状腺激素 代谢综合征 

分 类 号：R589[医药卫生—内分泌]