大样本体检人群中亚临床甲状腺功能减退与肾功能的相关性研究  

Association of subclinical hypothyroidism with renal function in a larger health check-up population

作　　者：王坤林[1] 陈吉海[1] 娄青林[1] 唐伟[1] 卞茸文[1] 

机构地区：[1]江苏省老年医院内分泌科,江苏省南京市210024

出　　处：《实用老年医学》2016年第9期762-764,共3页Practical Geriatrics

基　　金：国家自然科学基金项目(71373132)

摘　　要：目的探讨亚临床甲状腺功能减退(甲减)患者甲状腺功能与肾功能之间的关系。方法从我院2012年8月至2013年8月42269例健康体检的对象中筛选出544例亚临床甲减患者作为研究对象,并从甲状腺功能正常的人群中筛选出性别及年龄匹配的个体544例作为正常对照组,计算2组人群预估的肾小球滤过率(e GFR),并将e GFR<60 ml/(min·1.73m2)定义为慢性肾功能不全(CKD)。结果人群中亚临床甲减的总体发病率为4.61%,女性发病率为5.96%,男性发病率为3.89%,女性发病率高于男性。亚临床甲减组与正常对照组之间肌酐(Cr)、e GFR、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺素(TSH)水平以及CKD的患病率差异均有统计学意义(P<0.05)。相关分析研究提示,2组e GFR均与TSH呈显著负相关(P<0.01),与FT3呈显著正相关(P<0.01),而与FT4的关系则不显著(P>0.05)。结论甲状腺功能与肾功能之间密切相关,常规监测亚临床甲减患者的肾功能具有一定的临床意义。Objective To explore the relationship of subclinical hypothyroidism（ SCH） with renal function.Methods 544 cases of SCH（ SCH group） and 544 healthy control（ control group） matched in sex and age were enrolled and evaluated from the database of 42269 adults in the health check-up center of Jiangsu Province Official Hospital from August 2012 to August 2013. Estimated glomerular filtration rate（ e GFR） was calculated using Chinese modified Modification of Diet in Renal Disease（ CMDRD） equation,while moderate chronic kidney disease（ CKD） was defined as e GFR 〈60 ml /（ min·1. 73 m^2）. Results The prevalence of SCH was 4. 61% in total,5. 96% in women and 3. 89% in men respectively. There were significant difference in the levels of creatinine（ Cr）,e GFR,free triiodothyronine（ FT3）,free thyronine（ FT4）,thyroid stimulating hormone（ TSH）,and the incidence rate of CKD between two groups. A significant negative correlation was observed between TSH and e GFR in two groups（ P〈0. 01）,while positive correlation was found between FT3 and e GFR（ P〈0. 01）. There was no significant correlation between FT4 and e GFR in two groups（ P〉0. 05）.Conclusions There is a close relationship between the biochemical parameters of renal function and SCH status,and monitoring renal function in SCH patients has important clinical significance.

关 键 词：亚临床甲状腺功能减退 预估的肾小球滤过率 促甲状腺激素 慢性肾脏病 

分 类 号：R581.2[医药卫生—内分泌]