Study on the relationship between thyroid hormone sensitivity and diabetic kidney disease in type 2 diabetes mellitus patients
10.3969/j.issn.1006-6187.2025.10.006
- VernacularTitle:2型糖尿病患者甲状腺激素敏感性与糖尿病肾脏疾病相关性的研究
- Author:
Xiaona XU
1
;
Yi WEI
1
;
Xiaogang WENG
1
;
Wei DU
1
Author Information
1. 453000 新乡医学院第三附属医院内分泌与代谢病科
- Publication Type:Journal Article
- Keywords:
Diabetes mellitus,type 2;
Diabetic kidney disease;
Thyroid hormone sensitivity
- From:
Chinese Journal of Diabetes
2025;33(10):750-754
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the correlation between thyroid hormone(TH)sensitivity and diabetic kidney disease(DKD)in patients with type 2 diabetes mellitus(T2DM).Methods A total of 949 T2DM patients with normal thyroid function were selected from the National Standardized Metabolic Disease Management Center database of our hospital between May 2020 and October 2024.All the patients were divided into DKD group(n=466)with urinary albumin/creatinine ratio(UACR)≥30 mg/g and simple T2DM group(n=483)with UACR<30 mg/g.Free triiodothyronine(FT3),free thyroxine(FT4),thyroid stimulating hormone(TSH),thyroid feedback quantification index(TFQI),thyroid stimulating hormone resistance index(TT4RI),thyroid stimulating hormone index(TSHI),FT3/FT4 were compared between the two groups.Results Body mass index(BMI),DM duration,subcutaneous fat area(SFA),blood urea nitrogen(BUN),serum creatinine(Scr),UACR,TSHI and FT4 were higher(P<0.05 or P<0.01),while FT3,TFQI was lower in DKD group than in T2DM group(P<0.05).Spearman correlation analysis showed that TT4RI was positively correlated with Scr(P<0.05),and FT3/FT4 was negatively correlated with UACR(P<0.05)in DKD group.TT4RI was positively correlated with UACR in T2DM group(P<0.05).Logistic regression analysis showed that FT3,BUN and BMI were influencing factors for DKD.The model formula was established as follows:DKD=0.711+0.102×BMI-0.002×SFA+0.138×BUN+0.007×Scr-0.578×FT3-0.089×FT4+0.750×TFQI-0.277×TSHI,which can forecasted the risk of DKD occurrence by 10%.The receiver operator characteristic curve evaluated the area under the curre of the above model formula as 0.705,the sensitivity was 49.1%,the specificity was 80.3%,and the cut-off value was 0.464.Conclusions With normal thyroid function,impaired central and peripheral TH sensitivity is correlated with T2DM combined with DKD,and elevated FT3 is a protective factor for T2DM combined with DKD.
