老年糖尿病肾病患者血清甲状腺激素水平与肾功能指标的相关性

Correlation among serum thyroid hormone levels and renal function indicators in elderly patients with diabetic nephropathy

目的:分析老年糖尿病肾病(DN)患者血清甲状腺激素水平与肾功能指标的相关性。方法:选取120例老年2型糖尿病(T2DM)患者为研究对象,按尿微量白蛋白排泄率(UAER)不同分为三组,单纯T2DM组(UAER<20μg/min)38例,DN微量白蛋白尿组(UAER为20~200μg/min)49例,DN大量白蛋白尿组(UAER>200μg/min)33例,比较三组甲状腺激素[促甲状腺激素(TSH)、游离甲状腺素(FT4)、游离三碘甲腺原氨酸(FT3)]和肾功能指标[肌酐(Cr)、尿素氮(BUN)、胱抑素C(CysC)]水平,采用Spearman秩相关系数法分析甲状腺激素水平和肾功能指标的相关性。结果:T2DM患者UAER水平越高,TSH水平越高,FT3水平越低,差异有统计学意义(P<0.05);T2DM患者UAER水平越高,Cr、BUN、CysC水平越高,差异有统计学意义(P<0.05);三组FT4水平比较,差异无统计学意义(P>0.05);Spearman秩相关系数法显示,FT3水平与Cr、BUN、CysC水平呈负相关(r=-0.746、-0.805、-0.893,P<0.05);TSH、FT4水平与Cr、BUN、CysC水平无明显相关性(P>0.05)。结论:老年DN患者FT3水平与Cr、BUN、CysC水平呈负相关。

Objective:To investigate correlation among serum thyroid hormone levels and renal function indexes in elderly patients with diabetic nephropathy(DN).Methods:120 elderly patients with type 2 diabetes mellitus(T2DM)were selected as the research objects,and were divided into three groups according to different urine microalbumin excretion rates(UAER):single T2DM group(UAER<20μg/min),38 cases;DN microalbuminuria group(UAER 20-200μg/min),49 cases;DN massive albuminuria group(UAER>200μg/min),33 cases.The levels of thyroid hormones[thyroid stimulating hormone(TSH),free thyroxine(FT4),free triiodothyronine(FT3)]and renal function indicators[creatinine(Cr),urea nitrogen(BUN),cystatin C(CysC)]were compared among the three groups.Spearman rank correlation coefficient method was used to analyze the correlation among the thyroid hormone levels and renal function indicator levels.Results:The higher the UAER level in the T2DM patients was,the higher the TSH level was,the lower the FT3 level was,and the differences were statistically significant(P<0.05).The higher the UAER level in the T2DM patients was,the higher the Cr,BUN,and CysC were,and the differences were statistically significant(P<0.05).However,there were no statistically significant differences in the FT4 level among the three groups(P>0.05).The Spearman rank correlation coefficient method showed that the FT3 level was negatively correlated with the Cr,BUN,and CysC levels(r=-0.746,-0.805,-0.893,P<0.05),and the TSH and FT4 levels were not significantly correlated with the Cr,BUN,and CysC levels(P>0.05).Conclusions:For the elderly patients with DN,the FT3 level is negatively correlated with the Cr,BUN,and CysC levels.