2型糖尿病合并亚临床甲状腺功能减低与肾脏损害相关分析  

Correlation between subclinical hypothyroidism and diabetic nephropathy in the patients with type 2 diabetes mellitus

作　　者：陈晓蕾[1] 贾农[1] 柯亭羽[2] 田林玉 蔡丽萍[1] 杨林[1] 宋琳 杨悦林[1] 尹剑辉[1] 

机构地区：[1]昆明市第一人民医院内分泌,云南昆明650031 [2]昆明医科大学第二附属医院老年内分泌科,云南昆明650101

出　　处：《中国实用内科杂志》2018年第1期65-68,共4页Chinese Journal of Practical Internal Medicine

基　　金：云南省科技厅云医联合专项[2017FE468(-209)];昆明市科技局项目(2014-04-A-S-02-3118)

摘　　要：目的探讨亚临床甲状腺功能减低(简称甲减)与糖尿病肾病的相关性及可能机制。方法收集2015-2016年昆明市第一人民医院内分泌科154例2型糖尿病合并亚临床甲减患者及183例单纯糖尿病住院患者资料,采用计算机SPSS17.0统计学软件进行资料的统计学分析。结果研究组指标肾小球滤过率(e GFR)、尿酸(SUA)与胱抑素C(CYSC)差异有统计学意义(P<0.05)。校正年龄因素、病程、体重指数(BMI)及糖化血红蛋白(HbA_1c)后,TSH与CYSC正相关(r=0.291,P<0.01)。多因素非条件Logistic回归提示:高促甲状腺激素水平(TSH)是糖尿病肾病(OR1.14,95%CI 1.04-1.22,P<0.05)的独立危险因素。结论亚临床甲减与2型糖尿病肾脏损害相关,可能促进糖尿病肾脏病变的发生发展。Objective To investigate the correlation of subclinical hypothyroidism （SCH） with diabetic nephropathy （DKD） and its possible mechanism. Methods Total 337 T2DM patients, 154 with SCH and 183 without SCH as control group. SPSS17.0 statistical software is used for statistical analysis. Results SCH positive group had statistical difference in the index of eGFR SUA CYSC compared with control group（P〈0.05）. After correction of age factor, duration, BMI and HbAlc, there was a positive correlation between TSH and CYSC（r=0.291, P〈0.01）. Multivariate unconditional Logistic regression indicated that elevated thyroid stimulating hormone levels （TSH） were independent risk factors for diabetic nephropathy （OR 1.14, 95%CI 1.04-1.22, P〈0.05）. Conclution There is a correlation between subclinical hypothyroidism and diabetic nephropathy and may contribute to the development of diabetic nephropathy.

关 键 词：2型糖尿病 亚临床甲减 2型糖尿病性肾脏病 尿酸 胱抑素C 

分 类 号：R587.1[医药卫生—内分泌]