2型糖尿病患者亚临床甲状腺功能减退与白蛋白尿的关系研究

Relationship between Subclinical Hypothyroidism and Albuminuria in Patients with Type 2 Diabetes Mellitus

目的探讨2型糖尿病合并亚临床甲状腺功能减退患者的临床特征,分析SCH与24 h白蛋白尿排泄率的关系。方法采用回顾性研究方法,选取在我院内分泌科住院的资料完整的826例T2DM患者,分析患者的一般资料、生化指标、甲状腺功能和UAER,同时将SCH患者按蛋白尿分层,比较各组甲状腺功能。采用非条件Logistic多元逐步回归分析SCH与UAER的关系。结果 18.40%的T2DM患者合并SCH,SCH组患者e GFR较低而UAER较高(P<0.05),SCH合并蛋白尿组患者FT4下降,TSH升高(P<0.05)。Logistic回归分析显示,血清TSH水平是UAER的独立危险因素(r=0.353,P<0.05)。结论 T2DM合并SCH患者UAER升高,SCH是T2DM患者合并白蛋白尿的独立危险因素。

Objective To investigate the clinical characteristics of patients with type 2 diabetes mellitus complicated with subclinical hypothyroidism and the relationship between SCH and 24 h albuminuria excretion rate.Methods A retrospective study was conducted to select 826 T2DM patients with complete data in our hospital for endocrinology.The general data,biochemical indexes,thyroid function and UAER were analyzed.Patients with SCH were stratified by proteinuria and the thyroid function was compared between groups.The relationship between SCH and UAER was analyzed by non-conditional Logistic multiple stepwise regression.Results 18.40%of T2DM patients with SCH,SCH patients with lower eGFR and higher UAER(P<0.05),patients with SCH combined proteinuria FT4 decreased,TSH increased(P<0.05).Logistic regression analysis showed that serum TSH level was an independent risk factor for UAER(r=0.353,P<0.05).Conclusion UAER is elevated in patients with T2DM complicated with SCH,SCH is an independent risk factor for albuminuria in T2DM patients.