CAJ | 학술논문

目的：初步探讨2型糖尿病患者中亚临床甲状腺功能减退（SCH）与肾脏功能的关系。方法连续收集2008年1月至2012年12月于解放军161医院住院并行血清甲状腺功能测定的2型糖尿病患者472例，排除38例后，将其余434例患者分为SCH组（63例）及甲状腺功能正常组（371例），对其一般资料及相关实验室检查结果进行比较分析，并采用有序logistic回归进行危险因素分析。结果与甲状腺功能正常组比较， SCH组的女性患者比例（63.49%）、体质量指数（25.57±3.25）kg/m2、高血压病发病率（69.84%）及心脑血管病发病率（57.14%）显著增高（P＜0.05）；糖化血红蛋白（8.94%±1.03%）、血清肌酐（97.70±20.80）μmol/L、血清尿素氮（8.22±3.64）mmol/L、血清总胆固醇（5.83±1.08）mmol/L及血清低密度脂蛋白胆固醇（3.86±1.21）mmol/L均显著高于甲状腺功能正常组（P＜0.05）。有序logistic回归分析显示高血压病、促甲状腺激素升高及糖化血红蛋白升高与2型糖尿病患者肾脏损害程度相关（ P值均＜0.05）。结论除高血压病及高血糖外，SCH也可能与2型糖尿病患者肾脏损害严重程度相关。
목적：초보탐토2형당뇨병환자중아림상갑상선공능감퇴（SCH）여신장공능적관계。방법련속수집2008년1월지2012년12월우해방군161의원주원병행혈청갑상선공능측정적2형당뇨병환자472례，배제38례후，장기여434례환자분위SCH조（63례）급갑상선공능정상조（371례），대기일반자료급상관실험실검사결과진행비교분석，병채용유서logistic회귀진행위험인소분석。결과여갑상선공능정상조비교， SCH조적녀성환자비례（63.49%）、체질량지수（25.57±3.25）kg/m2、고혈압병발병솔（69.84%）급심뇌혈관병발병솔（57.14%）현저증고（P＜0.05）；당화혈홍단백（8.94%±1.03%）、혈청기항（97.70±20.80）μmol/L、혈청뇨소담（8.22±3.64）mmol/L、혈청총담고순（5.83±1.08）mmol/L급혈청저밀도지단백담고순（3.86±1.21）mmol/L균현저고우갑상선공능정상조（P＜0.05）。유서logistic회귀분석현시고혈압병、촉갑상선격소승고급당화혈홍단백승고여2형당뇨병환자신장손해정도상관（ P치균＜0.05）。결론제고혈압병급고혈당외，SCH야가능여2형당뇨병환자신장손해엄중정도상관。
Objective To investigate the relationship of subclinical hypothyroidism (SCH) with kidney function in patients with type 2 diabetes mellitus (T2DM). Methods A total of 472 hospitalized patients with T2DM receiving serum thyroid function test from January 2008 to December 2012 were subjected in this study. After 38 cases were excluded, the left 434 patients were divided into euthyroid group (n=371) and SCH group (n=63) according to serum thyroid function test. Their general condition and clinical data were collected and analyzed. An ordinal logistic regression analysis was conducted to determine the risk factors. Results Compared with the euthyroid group, the percentage of females (63.49%), body mass index [(25.57±3.25)kg/m2], and the prevalence of hypertension (69.84%) and cardiovascular disease (57.14%) were statistically higher in the SCH group (P<0.05); and so did the glycosylated hemoglobin [HbA1c, (8.94%±1.03%)], serum creatinine [(97.70±20.80)μmol/L], blood urea nitrogen [(8.22±3.64)mmol/L], total cholesterol [(5.83±1.08)mmol/L] and low density lipoprotein cholesterol [(3.86±1.21)mmol/L, all P<0.05]. Ordinal logistic regression analysis revealed that hypertension, elevated thyroid stimulating hormone and HbA1c were significantly associated with kidney dysfunction in T2DM patients (P<0.05). Conclusion Besides hypertension and hyperglycemia, SCH is related to the severity of kidney dysfunction in T2DM patients.