老年2型糖尿病患者亚临床甲状腺功能减退与糖尿病肾病的关系

Relationship between subclinical hypothyroidism and diabetic nephropathy in type 2 diabetic patients

目的探讨老年2型糖尿病患者亚临床甲状腺功能减退与糖尿病肾病的关系。方法回顾性分析2015年1月至2016年12月在我院内分泌科就诊的218例老年2型糖尿病患者临床病例资料，根据促甲状腺激素（TSH）水平不同分为观察组（TSH）〉4．20mU／L和对照组（TSH）为0．35～4．20mU／L，并分析老年2型糖尿病患者中亚临床甲状腺功能减退与糖尿病肾病之间的关系。结果218例老年2型糖尿病患者中亚临床甲状腺功能减退者46例，甲状腺功能正常组172例；甲状腺功能正常患者糖尿病肾病发生率9．9％（17／172），与亚临床甲状腺功能减退患者发生率23．9%（11／46）比较，差异有统计学意义（x2=4．100，P=0．043）；亚临床甲状腺功能减退者中TSH≥10．0mU／L患者其糖尿病肾病发生率54．5%（12／22），明显高于TSH4．2～10．0mU／L者20．8％（5／24）（x2=3．122，P=0．014）。结论老年2型糖尿病患者中亚临床甲状腺功能减退者糖尿病‘肾病发生率明显高于甲状腺功能正常者，且TSH水平越高，其糖尿病肾病发生率越高。

Objective To investigate the relationship between subclinical hypothyroidism and diabetic nephropathy in type 2 diabetic patients （T2DM）. Methods We retrospectively analyzed the clinical data of 218 patients with T2DM treated at the Department of Endocrinology, Shanghai Tongren Hospital from January 2015 to December 2016. Based on the level of thyroid stimulating hormone （TSH） ,patients were divided into a hypothyroidism group （TSH 〉4.20 mU/L） and a control group （TSH 0.35-4.20 mU/L）, and the relationship between subclinical hypothyroidism and diabetic nephropathy was evaluated. Results There were 46 cases in the subclinical hypothyroidism group and 172 cases in the control group. The incidences of diabetic nephropathy were significantly different between the two groups （P 〈 0.05）.Furthermore, the incidence of diabetic nephropathy was significantly higher in patients with high levels of TSH （≥10.0 mU/L） than in those with low levels of TSH （〈10.0 mU/L） （P〈0.05）. Conclusions Diabetic patients with subclinical hypothyroidism are prone to diabetic nephropathy,so it is necessary to screen thyroid function.