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    2型糖尿病住院病人血清TSH水平与糖尿病肾病的相关性分析

    Correlation analysis of serum TSH levels and diabetic nephropathy in hospitalized type 2 diabetes mellitus patients

      摘要
    • 摘要:
      目的 探讨2型糖尿病(T2DM)住院病人血清TSH水平与糖尿病肾病(DKD)的相关性。
      方法 选取T2DM住院病人共150例，根据其TSH水平进行分组，非亚临床甲状腺功能减退症(SCH)组(0.4 mIU/L < TSH < 4 mIU/L)、SCH1组(4 mIU/L≤TSH < 10 mIU/L)和SCH2组(TSH≥10 mIU/L), 每组各50例；比较3组的一般资料、空腹血糖、糖化血红蛋白、血脂、肾功能指标水平，分析血清TSH水平与DKD的关系。
      结果 与非SCH组相比，SCH组尿白蛋白肌酐比水平升高，差异有统计学意义(P < 0.01)，SCH2组胱抑素C水平高于其余2组，肾小球滤过率水平低于其余2组，差异有统计学意义(P < 0.05)。TSH与尿白蛋白肌酐比呈显著正相关(r=0.629，P < 0.01)，与肾小球滤过率呈显著负相关(r=-0.280，P < 0.01)。二元logistic回归分析显示，TSH水平升高是T2DM病人发生DKD的影响因素。
      结论 伴有SCH的T2DM病人，血清TSH水平升高是发生DKD的危险因素。

       

      Abstract:
      Objective To investigate the correlation between serum TSH levels and diabetic kidney disease in hospitalized patients with type 2 diabetes mellitus.
      Methods A total of 150 patients with type 2 diabetes mellitus hospitalized were selected and grouped according to their TSH levels, non-subclinical hypothyroidism(SCH) group(0.4 mIU/L < THS < 4 mIU/L), SCH1 group(4 mIU/L≤TSH < 10 mIU/L) and SCH2 group(TSH≥10 mIU/L), with 50 cases in each group.The general data, fasting blood glucose, glycosylated hemoglobin, blood lipids, and renal function levels of the three groups were compared, and the relationship between serum TSH levels and diabetic nephropathy was analyzed.
      Results Compared with the non-SCH group, the urine albumin-to-creatinine ratio (UACR) level was elevated in the SCH group, with a statistically significant difference (P < 0.01).The Cys-C level in SCH2 group was higher than the other two groups, and eGFR level was lower than the other two groups, with statistically significant differences (P < 0.05).TSH showed a significant positive correlation with UACR (r=0.629, P < 0.01) and a significant negative correlation with eGFR (r=-0.280, P < 0.01).Binary logistic regression analysis showed that elevated TSH levels were an influencing factor in the development of diabetic nephropathy in patients with type 2 diabetes mellitus.
      Conclusions Elevated serum TSH levels are a risk factor in the development of diabetic nephropathy in patients with type 2 diabetes mellitus with subclinical hypothyroidism.

       

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