亚临床甲状腺功能减退对2型糖尿病患者肾脏损害的影响

（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。

Effect of subclinical hypothyroidism on kidney dysfunction in patients with type 2 diabetes mellitus

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.