Study On Change Of Serum Thyroid Hormone And Its Correlation In Type2Diabetic Nephropathy

Study On Change Of Serum Thyroid Hormone And Its Correlation In Type2Diabetic NephropathyPurpose:To compare the changes of thyroid hormone levels in normal glucose tolerance group, type2diabetes (T2DM), early diabetes nephropathy group and clinical diabetes nephropathy group. The correlation between thyroid hormone and various metabolic indices in type2diabetic nephropathy was observed in order to explore a pathogenesis of metabolic disorders, and look for new ways to provide a theoretical basis for treatment and prognosis in type2diabetic nephropathy.Method:One hundred and forty eight patients with type2diabetes were selected who stayed in Department of Endocrinology of First Hospital of Jilin University from August in2010to August in2011,35-79years old, while patients in the diet patterns of life, count the amount of urine specimens of24hours, take10ml of urine to detect the24hour albumin excretion (UAE). The next morning after12hours’fasting, draw venous blood and inspected, measured fasting plasma glucose (FPG), glycosylated hemoglobin (HbAlc), serum creatinine (SCr), triglycerides(TG), high density lipoprotein cholesterol(HDL-C), low density lipoprotein cholesterol(LDL-C), uric acid (UA), thyroid stimulating hormone(TSH), thyroid hormones free tri-iodothyronine(FT3), free thyroxine(FT4).According to the measured results of urinary albumin excretion,patients were divided into three groups:①roup A:simple diabetic group (24-hour urinary albumin excretion<30mg);②roup B:early DN group (24-hour urinary albumin excretion=30～300mg);③roup C:clinical DN group ((24-hour urinary albumin excretion≥300mg). Method:And thirty cases of normal glucose tolerance were selected in our hospital medical examination center.Analyzed the differences between all the groups.The metabolic parameters:fasting plasma glucose (FPG), glycosylated hemoglobin (HbAlc), serum creatinine (SCr), triglycerides(TG), high density lipoprotein cholesterol(HDL-C), low density lipoprotein cholesterol(LDL-C), uric acid (UA) were dependent variables. Thyroid hormones free tri-iodothyronine(FT3), free thyroxine(FT4) were dependent variables respectively.Correlation between thyroid hormones and the metabolic indices above in type2diabetes nephropathy were observed.Result:1.The levels of FT3in the T2DM group were lower than in the NGT group,the difference was statistically significant (P<0.05). The levels of FT3in the early DN group were lower than in the NGT group and the T2DM group, the difference was statistically significant (P<0.05). The levels of FT4in the early DN group were lower than in the T2DM group,the difference was statistically significant (P<0.05). The levels of FT3in the clinical DN group were lower than in the NGT group and the T2DM group and early DN group, the difference was statistically significant (P<0.05). The levels of FT4in the clinical DN group were lower than in the T2DM group,the difference was statistically significant (P<0.05).2.Course of disease(X1), Scr(X2),FPG(X3) were related independently to FT3(Y)(Y=7.738-0.103X1-0.009X2-0.099X3P1=0.003、P2=0.001, P3=0.023), TG (X1)、HDL-L(X1) were related independently to FT4(Y)(Y=15.072-0.636X1+1.750X2P1=0.03、P2=0.001).Conclusion:1. The decreased levels of FT3and FT4were related to the occurrence and development of DN, regarded as one of important indexes for determining the conditions.2.The decreased levels of FT3were related to the glycol metabolism disorder; the decreased levels of FT4were related to the lipid metabolism disorder in the DN group.