Wang Jian, Li Huiqin, Tan Mingjuan, Gao Gu, Zhang Ying, Ding Bo, Su Xiaofei, Kong Xiaocen, Ma Jianhua
Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210012, China.
Department of Clinical Laboratory, Nanjing First Hospital, Nanjing Medical University, Nanjing 210012, China.
Oncotarget. 2019 Jan 4;10(2):88-97. doi: 10.18632/oncotarget.26265.
Previous studies have suggested that even in euthyroid subjects, thyroid function may affect the risk factors of diabetic nephropathy (DN). Thus, we investigated the association between thyroid parameters and DN in euthyroid subjects with type 2 diabetes mellitus (T2DM). This was a cross-sectional study of 1,071 euthyroid subjects with T2DM (mean age of 61.90 ± 12.74 years; 622 men). Clinical factors, including levels of free triiodothyronine (FT3), free thyroxine (FT4), thyroid-stimulating hormone (TSH), thyroid autoantibodies, albumin excretion rate were measured. DN was present in 400 (37.35%) individuals. Patients with DN exhibited higher serum TSH and lower serum FT3 and FT4 levels than those without DN (0.05). After adjusting traditional risk factors of DN, the levels of both FT3 (per-SD increase, odds ratio [OR] 0.606 [95% confidence interval (CI), 0.481-0.762], <0.001) and FT4 (per-SD increase, OR 0.944 [0.894-0.998], = 0.040) were inversely correlated with DN. Meanwhile, we found that serum TSH levels were positively correlated with DN (per-SD increase, OR1.179 [1.033-1.346], = 0.015). Low-to-normal thyroid hormones (THs) were also associated with the presence of macroalbuminuria. In conclusion, the relatively low levels of THs were significantly associated with DN in euthyroid subjects with T2DM.
先前的研究表明，即使在甲状腺功能正常的受试者中，甲状腺功能也可能影响糖尿病肾病（DN）的危险因素。因此，我们调查了甲状腺功能正常的2型糖尿病（T2DM）患者甲状腺参数与DN之间的关联。这是一项对1071名甲状腺功能正常的T2DM患者的横断面研究（平均年龄61.90±12.74岁；男性622名）。测量了临床因素，包括游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）、促甲状腺激素（TSH）、甲状腺自身抗体、白蛋白排泄率。400名（37.35%）个体存在DN。与无DN的患者相比，DN患者的血清TSH水平更高，血清FT3和FT4水平更低（P<0.05）。在调整DN的传统危险因素后，FT3（每标准差增加，比值比[OR]0.606[95%置信区间（CI），0.481 - 0.762]，P<0.001）和FT4（每标准差增加，OR 0.944[0.894 - 0.998]，P = 0.040）水平均与DN呈负相关。同时，我们发现血清TSH水平与DN呈正相关（每标准差增加，OR1.179[1.033 - 1.346]，P = 0.015）。甲状腺激素（THs）水平低至正常也与大量蛋白尿的存在有关。总之，在甲状腺功能正常的T2DM患者中，相对较低的THs水平与DN显著相关。
