Department of Nephropathy, Beijing Traditional Chinese Medicine Hospital, Capital Medical University, Beijing, China.
Beijing University of Chinese Medicine, Beijing, China.
BMC Endocr Disord. 2023 Mar 8;23(1):56. doi: 10.1186/s12902-023-01299-1.
We aimed to explore the association between thyroid hormones and different stages of diabetic kidney disease (DKD) in Chinese adults.
This is a retrospective study involving 2,832 participants. DKD was diagnosed and classified according to the Kidney Disease: Improving Global Outcomes (KDIGO) categories. Effect sizes are expressed as odds ratio (OR) with 95% confidence interval (CI).
After propensity score matching (PSM) on age, gender, hypertension, hemoglobin A1c(HbA1c), total cholesterol (TC), serum triglyceride (TG) and duration of diabetes, per 0.2 pg/mL increment in serum free triiodothyronine (FT3) was significantly associated with 13%, 22% and 37% reduced risk of moderate-risk (OR, 95% CI, P: 0.87, 0.70-0.87, < 0.001), high-risk (0.78, 0.70-0.87, < 0.001) and very-high-risk (0.63, 0.55-0.72, < 0.001) DKD stages relative to the low-risk DKD stage, respectively. After PSM analyses, serum FT4 and TSH showed no statistical significance in risk estimates for all DKD stages. To facilitate clinical application, a nomogram prediction model was established for the moderate-risk, high-risk and very-high-risk DKD stages, with decent accuracy.
Our results indicate that high concentrations of serum FT3 were associated with the significantly reduced risk of having moderate-risk to very-high-risk DKD stages.
我们旨在探讨中国成年人甲状腺激素与糖尿病肾病(DKD)不同阶段的关系。
这是一项回顾性研究,共纳入了 2832 名参与者。DKD 根据肾脏病:改善全球预后(KDIGO)标准进行诊断和分类。效应大小表示为比值比(OR)及其 95%置信区间(CI)。
在年龄、性别、高血压、糖化血红蛋白(HbA1c)、总胆固醇(TC)、血清甘油三酯(TG)和糖尿病病程进行倾向评分匹配(PSM)后,血清游离三碘甲状腺原氨酸(FT3)每增加 0.2 pg/mL,与中度风险(OR,95%CI,P:0.87,0.70-0.87,<0.001)、高风险(0.78,0.70-0.87,<0.001)和极高风险(0.63,0.55-0.72,<0.001)DKD 阶段的风险降低分别相关。PSM 分析后,血清 FT4 和 TSH 对所有 DKD 阶段的风险估计均无统计学意义。为便于临床应用,我们为中度风险、高风险和极高风险 DKD 阶段建立了列线图预测模型,具有较好的准确性。
我们的研究结果表明,血清 FT3 浓度升高与中度至极高风险 DKD 阶段的风险显著降低有关。