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中国成年人甲状腺激素与糖尿病肾病的关系。

Association between thyroid hormones and diabetic kidney disease in Chinese adults.

机构信息

Department of Nephropathy, Beijing Traditional Chinese Medicine Hospital, Capital Medical University, Beijing, China.

Beijing University of Chinese Medicine, Beijing, China.

出版信息

BMC Endocr Disord. 2023 Mar 8;23(1):56. doi: 10.1186/s12902-023-01299-1.

Abstract

OBJECTIVE

We aimed to explore the association between thyroid hormones and different stages of diabetic kidney disease (DKD) in Chinese adults.

METHODS

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).

RESULTS

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.

CONCLUSION

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.

摘要

目的

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。

方法

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)。

结果

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。

结论

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/35fd/9993682/1684f358fc21/12902_2023_1299_Fig1_HTML.jpg

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