2型糖尿病住院患者碘营养及尿碘校正研究

Iodine nutrition and urinary iodine correction in inpatients with type 2 diabetes mellitus

目的通过测定尿碘评价糖尿病患者碘营养,探讨尿碘肌酐比值指标是否适用于糖尿病患者的碘营养评价,探究尿糖对尿碘排泄的影响。方法以2型糖尿病患者为研究对象,时间为2017年9月至2018年2月,最终尿碘资料收集齐全者98例,收集患者入院出院时的24 h尿样本、随机尿各1份,检测尿碘24 h排出量、随机尿碘及尿肌酐浓度,计算随机尿尿碘与肌酐浓度的比值,评价患者碘营养情况,分析尿碘与肌酐比值相关性,探究尿糖对尿碘排泄的影响。结果(1)入院和出院时2型糖尿病患者24 h尿碘排出量提示患者处于碘营养充足状态[219.05(161.00,333.13)μg/d vs.212.88(133.48,318.65)μg/d],P>0.05]。(2)入院和出院时24 h尿碘排出量与尿碘肌酐比值呈强相关(分别为r=0.621、r=0.724,P<0.001),且相关性高于随机尿碘浓度。(3)入院和出院时尿糖排出量差异有统计学意义[(6.96±3.88)g/d vs.(2.21±2.05)g/d,t=11.494,P=0.000)。结论2型糖尿病患者处于碘充足状态;24 h尿碘排出量与尿碘肌酐比值呈强相关性;尿糖的排出对尿碘排泄无明显影响。

Objectives To evaluate the iodine nutrition of diabetic patients by measuring urinary iodine,to explore whether the ratio index of urinary iodine creatinine is suitable for the evaluation of iodine nutrition of diabetic patients,and to explore the influence of urine sugar on urinary iodine excretion.Methods The subjects of the study were patients with type 2 diabetes,and total 98 patients with urinary iodine were collected between September 2017 and February 2018.One 24-hour urine sample and one random urine sample were collected from the patients upon admission and discharge to detect the 24-hour excretion of urinary iodine,random urinary iodine and urinary creatinine concentration.The ratio of random urinary iodine to creatinine concentration were calculated to evaluate the patients’iodine nutrition.Then analyze the correlation between the ratio of urinary iodine and creatinine,and explore the influence of urine sugar on urinary iodine excretion.Results The 24-hour urine iodine excretion of type 2 diabetic patients upon admission and discharge indicates that the patient is in a state of adequate iodine nutrition[219.05(161.00,333.13)vs.212.88(133.48,318.65)],P>0.05].The 24-hour urinary iodine excretion at admission and discharge has a strong correlation with the urinary iodine-creatinine ratio(r=0.621,r=0.724,P<0.001),and the correlation is higher than the random urinary iodine concentration.There was a statistically significant difference in urine glucose excretion between admission and discharge(6.96±3.88 vs.2.21±2.05,t=11.494,P=0.000).Conclusions Type 2 diabetes patients are in a state of iodine sufficient.The 24-hour urinary iodine excretion has a strong correlation with the urinary iodine-creatinine ratio.The excretion of urinary sugar has no obvious effect on urinary iodine excretion.