2型糖尿病患者尿视黄醇结合蛋白4与促甲状腺激素的相关性  

Correlation between urinary RBP4 and TSH levels among patients with type 2 diabetes mellitus

作　　者：朱胜乾 吴晓明[1] 赵伟[1] 张晓会[1] 任焕欣 张宏[1] 

机构地区：[1]天津医科大学代谢病医院内分泌研究所,天津300070

出　　处：《中国慢性病预防与控制》2015年第10期725-727,共3页Chinese Journal of Prevention and Control of Chronic Diseases

摘　　要：目的探讨2型糖尿病（T2DM）患者尿视黄醇结合蛋白4（urinary retinol binding protein,URBP4）与血促甲状腺激素（TSH）的关系,为T2DM伴TSH升高患者的治疗提供依据。方法选取2013年7月至2014年8月在天津医科大学代谢病医院首次住院的396例T2DM患者为研究对象,其中男性236例,女性160例,年龄22~84岁,平均（55.5±10.8）岁。根据URBP4水平,将患者分为A组（URBP4≤0.7 mg/L）与B组（URBP4〉0.7 mg/L）,并收集相关临床资料及实验室检查结果进行比较。结果 B组收缩压（SBP）、舒张压（DBP）、体质指数（BMI）、尿微量白蛋白（MAU）、24 h尿蛋白定量（24 h UTP）、尿转铁蛋白（UTRF）、尿半乳糖苷酶（UGal）、尿N-乙酰-β-D-葡萄糖苷酶（UNAG）、尿免疫球蛋白Ig G（UIg G）、URBP4及尿β2微球蛋白（Uβ2-MG）[分别为（139.70±19.76）mm Hg、（86.36±12.26）mm Hg、（27.22±3.91）kg/m2、67.09（22.51,194.44）mg/24 h、0.20（0.12,0.52）g/24 h、3.74（1.03,8.48）mg/L、4.76（3.01,10.40）U/L、11.05（6.32,17.84）U/L、8.95（4.64,12.92）mg/L、11.05（6.32,17.83）mg/L及0.26（0.11,0.47）mg/L]均明显高于A组[分别为（131.14±16.88）mm Hg、（80.33±11.87）mm Hg、（26.03±3.51）kg/m2、15.01（12.53,18.52）mg/24 h、0.09（0.07,0.11）g/24 h、0.92（0.30,1.60）mg/L、2.94（1.31,5.09）U/L、8.60（5.63,13.12）U/L、2.45（1.22,4.13）mg/L、0.29（0.15,0.82）mg/L及0.11（0.06,0.19）mg/L],差异均有统计学意义（P〈0.01）;线性相关分析显示,URBP4与TSH、MAU、UTP、血肌酐、血尿酸、SBP、DBP、Uβ2-MG、UTRF及UGal均呈正相关（P〈0.01）;多元逐步回归分析显示,TSH、MAU、UGal、UTRF及DBP是URBP4的独立影响因素（P〈0.01,P〈0.05）。结论 TSH与URBP4密切相关,糖尿病患者伴TSH升高的患者应高度关注其肾病的发生和发展。Objective To investigate the relationship between urinary retinol binding protein（URBP4） and serum thyroid stimulating hormone（TSH） among patients with type 2 diabetes mellitus（T2DM） and provide the base for treating T2 DM patients with high TSH. Methods From July of 2013 to August of 2014, 396 T2 DM patients were served as subjects（236 male cases and 160 female cases） with average age 55.5±10.8 years old（22-84 years old）. The subjects were divided into A group（URBP4≤0.7 mg/L） and B group（URBP40.7 mg/L） according to URBP4 levels. The clinical data and laboratory test results were collected and analyzed.Results The systolic blood pressure（SBP）, diastolic blood pressure（DBP）, body mass index（BMI）, microalbuminuria（MAU）,24 h total urine protein（UTP）, UTRF, UGal, UNAG, UIg G, URBP4 and Uβ2-MG in group B were significantly higher than those in A group（P〈0.01）. The URBP4 level was positively correlated with TSH, MAU, UTP, blood creatinine, blood uric acid, SBP,DBP, Uβ2-MG, UTRF and UGal in patients（P〈0.01）. Multiple stepwise regression analysis indicated that TSH, MAU, UTRF,UGal and DBP were independent influencing factors for URBP4（P〈0.01 or P〈0.05）. Conclusion TSH is closely related to the URBP4, the diabetic patients with high TSH should pay attention to the progression of diabetic nephropathy.

关 键 词：促甲状腺激素 尿视黄醇结合蛋白4 糖尿病 2型 

分 类 号：R587.1[医药卫生—内分泌]