2型糖尿病患者低T_3综合征与微量白蛋白尿发生的相关性分析  

An analysis of relationship between low T_3 syndrome and microalbuminuria in patients with type 2 diabetic mellitus

作　　者：王菲[1] 汪剑[2] 孔小岑[2] 李惠琴[2] 谭明娟[3] 

机构地区：[1]南京医科大学附属妇产医院(南京市妇幼保健院)药剂科,江苏210013 [2]南京医科大学附属南京医院内分泌科 [3]南京医科大学附属南京医院检验科

出　　处：《江苏医药》2018年第2期142-145,共4页Jiangsu Medical Journal

基　　金：国家自然科学基金青年基金(81400840)

摘　　要：目的探讨促甲状腺激素(TSH)正常的2型糖尿病(T2DM)患者低三碘甲状腺原氨酸(T_3)综合征与微量白蛋白尿发生的相关性。方法 392例T2DM患者根据24-h尿白蛋白排泄率(AER)分为两组:正常白蛋白尿组(A组,253例,AER<30mg/24h)、微量白蛋白尿组(B组,139例,30mg/24h≤AER<300mg/24h)。检测血浆ALT、AST、TC、TG、HDL-C、LDL-C、BUN、SCr、HbA1c、FT_3、FT_4和TSH水平及24-h尿白蛋白定量,分析甲状腺功能和微量白蛋白尿的相关性。结果与A组相比,B组FT_3水平较低[(4.33±0.60)pmol/L vs.(4.54±0.52)pmol/L](P<0.01),低T_3综合征发生率较高(9.35%vs.2.85%)(P<0.01)。Spearman线性相关分析显示,24-h尿白蛋白与FT_3呈负相关(rs=-0.163,P<0.01)。多元线性回归分析结果显示,FT_3与24-h尿白蛋白呈负相关(β=-0.148,P<0.05)。低T_3综合征组24-h尿白蛋白和微量白蛋白尿发生率高于正常甲状腺功能组[(82.82±93.38)mg/24hvs.(37.53±52.47)mg/24h和65.00%vs.46.32%](P<0.01)。结论 TSH正常的T2DM患者低FT_3水平及低T_3综合征与微量白蛋白尿发生密切相关。Objective To investigate the correlation between low-triiodothyronine （T3） syndrome and microalbuminuria in type 2 diabetes mellitus （T2DM） patients with normal thyroid-stimulating hormone（TSH）. Methods Ninety-two patients with T2DM were divided into two groups of A（AER〈30 rag/24 h,253 cases） and B（30 rag/24 h≤AER〈300 rag/24 h, 139 cases）. The ALT, AST,TC,TG, HDL-C, LDL-C, BUN, SCr, HbAle, VT3, FT4, TSH and 24-h urinary albumin were measured. The correlation between thyroid function and microalbuminuria was analyzed. Results Compared with group A,the level of FT3 in group B was lowerS（4.33±0.60） pmol/L vs. （4. 54±0.52） pmol/L] （P〈0. 01） and the incidence of low T3 syndrome was higher（9.35% vs. 2.85%） （P〈0. 01）. Spearman linear correlation analysis showed that 24-h urinary albumin was negatively correlated with FT3 （rs=-0. 163, P〈0.01）. Multiple linear regression analysis showed that FT3 was negatively correlated with 24-h urinary albumin （β=- 0. 148, P〈0. 05）. The level of 24-h urine albumin and the incidence of microalbuminuria were higher in the patients with low T3 syndrome than those with normal thyroid function[（82.82±93.38）mg/24 h vs. （37.53±52.47）mg/24 h and 65.00% vs. 46.32%]（P〈0. 01）. Conclusion Low FT3 levels and low T3 syndrome are closely correlated with microalbuminuria in T2DM patients with normal TSH.

关 键 词：2型糖尿病 微量白蛋白尿 低三碘甲状腺原氨酸综合征 

分 类 号：R587[医药卫生—内分泌]