维持性血液透析患者甲状腺激素、25羟维生素D3水平与营养指标的相关性

Correlation between thyroid hormone,25-hydroxyvitamin D3 levels and nutritional indicators in maintenance hemodialysis patients

目的:探究维持性血液透析患者甲状腺激素、25-羟维生素D3[25-(OH)D3]水平与营养指标的相关性。方法:选择2018年1月至2019年2月北京市密云区中医医院接收、诊治的维持性血液透析患者72例,纳入研究组;另选择北京市密云区中医医院同期体检健康的60例体检者,纳为对照组。检测两组甲状腺激素、25-(OH)D3水平与营养指标,并分析讨论甲状腺激素、25-(OH)D3水平与营养指标的相关性。结果:研究组总三碘甲状腺原氨酸(total triiodothyronine,TT3)、游离三碘甲状腺原氨酸(free triiodothyronine,FT3)、25-(OH)D3水平、血清白蛋白(seralbumin,ALB)、前白蛋白(pre-albumin,PA)及总蛋白(total protein,TP)水平均明显低于对照组(P<0.05);两组促甲状腺激素(thyroid-stimulating hormone,TSH)及球蛋白(globulin,GLOB)水平差异均无统计学意义(P>0.05);72例维持性血液透析患者中,有10例25-(OH)D3水平>30 ng/mL,51例25-(OH)D3水平在15~30 ng/mL,有11例25-(OH)D3水平<15 ng/mL;不同25-(OH)D3水平患者ALB,PA,TP水平均有差异(P<0.05);甲状腺激素与ALB,PA,TP,GLOB均不存在相关性(P>0.05);25-(OH)D3与ALB,TP,PA水平均表现为正相关(P<0.05),与GLOB水平无相关性(P>0.05)。结论:维持性血液透析患者普遍存在甲状腺激素降低、维生素D不足或缺乏、营养状况不佳的情况,且患者维生素D水平与患者营养指标均呈正相关。

Objective:To explore the correlation between thyroid hormone,25-(OH)D3 levels and nutritional indicators in maintenance hemodialysis patients.Methods:Seventy-two patients with maintenance hemodialysis received and treated in our hospital from January 2018 to February 2019 were enrolled in the study group;In addition,another 60 health check-up were selected in our hospital during the same period,and the patients were selected as the control group.The levels of thyroid hormone,25-(OH)D3 and nutritional indicators were measured in two groups,and the correlation between thyroid hormone and 25-(OH)D3 levels and nutritional indicators was analyzed.Results:The levels of total triiodothyronine(TT3),free triiodothyronine(FT3),25-(OH)D3,seralbumin(ALB),pre-albumin(PA)and total protein(TP)in the study group were significantly lower than those in the control group(P<0.05).There was no significant difference in thyroid-stimulating hormone(TSH)and globulin(GLOB)between the two groups(P>0.05).Among 72 patients with maintenance hemodialysis,there were 10 cases with 25-(OH)D3 levels>30 ng/mL,51 cases with 25-(OH)D3 levels ranging from 15 to 30 ng/mL,and 11 cases with 25-(OH)D3 levels<15 ng/mL.The levels of ALB,PA and TP in patients with different 25-(OH)D3 levels were significantly different(P<0.05).There was no correlation between thyroid hormone and ALB,PA,TP and GLOB(P>0.05).25-(OH)D3 was positively correlated with ALB,TP,PA(P<0.05),and there was no correlation with GLOB(P>0.05).Conclusion:Maintenance hemodialysis patients generally have thyroid hormone reduction,vitamin D deficiency or deficiency,and poor nutritional status,and the patient's vitamin D level is positively correlated with the patient’s nutritional index.