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在中国一所大学医院的横断面研究中,住院 2 型糖尿病患者的甲状腺自身抗体与糖尿病肾病的相关性。

Association of thyroid autoantibodies and diabetic kidney disease in hospitalised patients with type 2 diabetes mellitus: a cross-sectional study from a Chinese university hospital.

机构信息

Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, China.

Department of Endocrinology, Changchun Center Hospital, Changchun, China.

出版信息

BMJ Open. 2024 Mar 18;14(3):e077338. doi: 10.1136/bmjopen-2023-077338.

Abstract

OBJECTIVES

To analyse and explore the association between thyroid autoantibodies and diabetic kidney disease (DKD) in patients with type 2 diabetes mellitus (T2DM).

DESIGN

A cross-sectional study.

SETTING

Patients were from the inpatient unit at The Second Endocrinology Department of Shengjing Hospital Affiliated to China Medical University (Shenyang, China) between January 2015 and September 2019.

PARTICIPANTS

A total of 150 Chinese adults with T2DM were included in the study, including 83 men and 67 women. Their age ranged between 25 and 92 years.

METHODOLOGY

They grouped by the presence of DKD, urine albumin-to-creatinine ratio (UACR), estimated glomerular filtration rate, and levels of thyroid peroxidase antibodies (TPOAb) and thyroglobulin antibodies (TgAb). Data on the patients' general characteristics and laboratory measurements (levels of fasting plasma glucose, glycated haemoglobin, and albumin; renal function; and thyroid function) were collected. Binary logistic regression was performed to identify risk factors for DKD.

RESULTS

The level of TPOAb, the positivity rates of TPOAb (p<0.01) and TgAb (p<0.05) were higher in patients with DKD than in those without DKD. The TPOAb level in patients with a UACR<30 mg/g creatinine was lower than that in patients with a UACR between 30 and 300 mg/g creatinine (p<0.05). The prevalence of DKD was higher in patients with a TPOAb-positive or TgAb-positive status. The result of binary logistic regression analysis showed that a TPOAb-positive status was significantly associated with DKD in patients with T2DM (OR=7.683, 95% CI 1.583 to 37.286, p<0.05).

CONCLUSIONS

TPOAb-positive status is in association with DKD in patients with T2DM. Large scale, prospective cohort studies are warranted to confirm our findings.

摘要

目的

分析并探讨 2 型糖尿病(T2DM)患者甲状腺自身抗体与糖尿病肾脏疾病(DKD)的相关性。

设计

横断面研究。

地点

研究对象来自中国医科大学附属盛京医院第二内分泌科的住院患者(沈阳,中国),时间为 2015 年 1 月至 2019 年 9 月。

参与者

共纳入 150 例中国成年人 T2DM 患者,其中男 83 例,女 67 例,年龄 25-92 岁。

方法

根据 DKD、尿白蛋白/肌酐比值(UACR)、估算肾小球滤过率以及甲状腺过氧化物酶抗体(TPOAb)和甲状腺球蛋白抗体(TgAb)水平将患者分组。收集患者的一般特征和实验室测量值(空腹血糖、糖化血红蛋白和白蛋白水平;肾功能;甲状腺功能)数据。采用二元逻辑回归分析确定 DKD 的危险因素。

结果

与无 DKD 患者相比,DKD 患者的 TPOAb 水平、TPOAb 阳性率(p<0.01)和 TgAb 阳性率(p<0.05)更高。UACR<30 mg/g 肌酐的患者的 TPOAb 水平低于 UACR 在 30-300 mg/g 肌酐之间的患者(p<0.05)。TPOAb 阳性或 TgAb 阳性的患者 DKD 患病率更高。二元逻辑回归分析结果显示,TPOAb 阳性状态与 T2DM 患者的 DKD 显著相关(OR=7.683,95%CI 1.583-37.286,p<0.05)。

结论

TPOAb 阳性状态与 T2DM 患者的 DKD 相关。需要进行大规模、前瞻性队列研究来证实我们的发现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d03f/10952948/1d9d0369449e/bmjopen-2023-077338f01.jpg

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