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不要忘记甲状腺功能亢进症中的肾脏问题。

Do not forget the kidney in graves' disease.

机构信息

Department of Endocrinology, Metabolism, and Diabetes, Medical Faculty, Istanbul University-Cerrahpasa, Campus Kocamustafapasa Street No:53 Cerrahpasa, Fatih, 34098, Istanbul, Turkey.

Department of Internal Medicine, Istanbul University-Cerrahpasa, 34098, Istanbul, Turkey.

出版信息

Int Urol Nephrol. 2023 Oct;55(10):2667-2673. doi: 10.1007/s11255-023-03600-6. Epub 2023 Apr 24.

Abstract

PURPOSE

To investigate the prevalence of microalbuminuria and factors associated with microalbuminuria in Graves' Disease (GD).

METHODS

This cross-sectional and single-center study included 99 patients with GD and 47 healthy controls (HC). Exclusion criteria such as active infection, uncontrolled diabetes, and chronic kidney disease were applied to the participants. The participants' clinical findings, comorbidities, drug use, laboratory tests, and thyroid antibody levels were recorded. Spot urine samples were collected and stored at - 80 ℃ to analyze the presence of microalbuminuria.

RESULTS

The prevalence of microalbuminuria in patients with GD was 12.1%. The median microalbumin/creatinine ratio in spot urine (UACR) in patients with GD (9.49 mg/g [5.09-18.10]) was higher than in the HC group (7.99 mg/g [3.48-12.88], p = 0.033). UACR was correlated with thyroid-stimulating hormone receptor antibody (TRAb), thyroid-stimulating hormone (TSH), and free triiodothyronine (FT3) levels (p = 0.020, p = 0.006, p = 0.009 respectively). In the regression analysis, only the relationship between TRAb level and UACR remained (p = 0.040).

CONCLUSION

This study demonstrates an increased prevalence of microalbuminuria in patients with GD. There was a significant correlation between microalbuminuria and TRAb level in patients with GD. This relationship suggests that one of the underlying mechanisms of microalbuminuria seen in patients with GD may be autoimmunity.

摘要

目的

调查 Graves 病(GD)患者微量白蛋白尿的患病率及相关因素。

方法

本横断面单中心研究纳入了 99 例 GD 患者和 47 名健康对照者(HC)。对参与者应用了排除标准,如活动性感染、未控制的糖尿病和慢性肾脏病等。记录了参与者的临床发现、合并症、药物使用、实验室检查和甲状腺抗体水平。采集并储存点尿样,在-80℃下分析微量白蛋白尿的存在情况。

结果

GD 患者微量白蛋白尿的患病率为 12.1%。GD 患者点尿(UACR)中微量白蛋白/肌酐比值的中位数(9.49mg/g[5.09-18.10])高于 HC 组(7.99mg/g[3.48-12.88],p=0.033)。UACR 与促甲状腺激素受体抗体(TRAb)、促甲状腺激素(TSH)和游离三碘甲状腺原氨酸(FT3)水平相关(p=0.020,p=0.006,p=0.009)。在回归分析中,仅 TRAb 水平与 UACR 之间的关系仍具有统计学意义(p=0.040)。

结论

本研究表明 GD 患者微量白蛋白尿的患病率增加。GD 患者微量白蛋白尿与 TRAb 水平之间存在显著相关性。这种关系提示,GD 患者微量白蛋白尿的一个潜在机制可能是自身免疫。

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