Dengrong Ma, Pingping Zhao, Jie Gao, Xinyuan Guo, Mei Han, Xiaohui Zan, Chongyang Chen, Xiaoyu Lv, Jingfang Liu
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The patients were subdivided into four groups (<i>Q</i> <sub>1</sub> to <i>Q</i> <sub>4</sub>) based on the quartile levels of the five indices. The correlation between thyroid hormone sensitivity and DN was analyzed by binary logistic regression and restricted cubic spline (RCS) analysis.</p><p><strong>Results: </strong>The levels of PTFQI, TFQI, and TSHI in the DN group were higher than those in the Non-DN group [0.04(-0.21, 0.31) vs -0.003(-0.27, 0.25), 0.05(-0.20, 0.30) vs 0.006(-0.26, 0.25), 2.54±0.52 vs 2.47±0.51, all <i>P</i><0.05], while the FT3/FT4 levels were decreased in the DN group (0.40±0.07 vs 0.42±0.07, <i>P</i><0.05). Multivariate logistic regression analysis showed that the increase in PTFQI and TFQI levels was positively correlated with DN [OR=1.518, 95% CI(1.074, 2.145) and OR=1.546, 95% CI(1.084, 2.204)]. RCS showed a linear dose-response relationship between PTFQI, TFQI, TSHI, FT3/FT4, TT4RI, and the tendency of DN (all <i>P</i> <sub>non-linear</sub>>0.05). As the levels of PTFQI, TFQI, and TSHI increased, and the FT3/FT4 levels decreased, the prevalence of DN and the urinary albumin-to-creatinine (UACR) level showed an upward trend (all <i>P<sub>trend test</sub></i> <0.05), while the estimated glomerular filtration rate (eGFR) level showed a downward trend (all <i>P<sub>trend test</sub></i> <0.05).</p><p><strong>Conclusion: </strong>Among euthyroid patients with T2DM, impaired thyroid hormone sensitivity is associated with DN, as well as elevated UACR levels and decreased eGFR levels.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"1207-1221"},"PeriodicalIF":2.8000,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12034277/pdf/","citationCount":"0","resultStr":"{\"title\":\"The Correlation Between Impaired Thyroid Hormone Sensitivity and Diabetic Nephropathy in Euthyroid Patients with Type 2 Diabetes Mellitus.\",\"authors\":\"Dengrong Ma, Pingping Zhao, Jie Gao, Xinyuan Guo, Mei Han, Xiaohui Zan, Chongyang Chen, Xiaoyu Lv, Jingfang Liu\",\"doi\":\"10.2147/DMSO.S507750\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To investigate the association between impaired thyroid hormone sensitivity and diabetic nephropathy (DN) in euthyroid patients with type 2 diabetes mellitus (T2DM).</p><p><strong>Methods: </strong>1305 euthyroid patients with T2DM who were hospitalized in the Endocrinology Department of the First Hospital of Lanzhou University between July 2021 and August 2023 were selected. Several indices, such as the parameters thyroid feedback quantile index (PTFQI), thyroid feedback quantile index (TFQI), thyroid stimulating hormone index (TSHI), serum-free triiodothyronine to free thyroxine (FT3/FT4) ratio, and thyrotropin thyroxine resistance index (TT4RI) to evaluate thyroid hormone sensitivity were used. The patients were subdivided into four groups (<i>Q</i> <sub>1</sub> to <i>Q</i> <sub>4</sub>) based on the quartile levels of the five indices. The correlation between thyroid hormone sensitivity and DN was analyzed by binary logistic regression and restricted cubic spline (RCS) analysis.</p><p><strong>Results: </strong>The levels of PTFQI, TFQI, and TSHI in the DN group were higher than those in the Non-DN group [0.04(-0.21, 0.31) vs -0.003(-0.27, 0.25), 0.05(-0.20, 0.30) vs 0.006(-0.26, 0.25), 2.54±0.52 vs 2.47±0.51, all <i>P</i><0.05], while the FT3/FT4 levels were decreased in the DN group (0.40±0.07 vs 0.42±0.07, <i>P</i><0.05). Multivariate logistic regression analysis showed that the increase in PTFQI and TFQI levels was positively correlated with DN [OR=1.518, 95% CI(1.074, 2.145) and OR=1.546, 95% CI(1.084, 2.204)]. RCS showed a linear dose-response relationship between PTFQI, TFQI, TSHI, FT3/FT4, TT4RI, and the tendency of DN (all <i>P</i> <sub>non-linear</sub>>0.05). As the levels of PTFQI, TFQI, and TSHI increased, and the FT3/FT4 levels decreased, the prevalence of DN and the urinary albumin-to-creatinine (UACR) level showed an upward trend (all <i>P<sub>trend test</sub></i> <0.05), while the estimated glomerular filtration rate (eGFR) level showed a downward trend (all <i>P<sub>trend test</sub></i> <0.05).</p><p><strong>Conclusion: </strong>Among euthyroid patients with T2DM, impaired thyroid hormone sensitivity is associated with DN, as well as elevated UACR levels and decreased eGFR levels.</p>\",\"PeriodicalId\":11116,\"journal\":{\"name\":\"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy\",\"volume\":\"18 \",\"pages\":\"1207-1221\"},\"PeriodicalIF\":2.8000,\"publicationDate\":\"2025-04-23\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12034277/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2147/DMSO.S507750\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/DMSO.S507750","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
引用次数: 0
摘要
目的：探讨甲状腺功能正常的2型糖尿病（T2DM）患者甲状腺激素敏感性受损与糖尿病肾病（DN）的关系。方法：选取2021年7月~ 2023年8月兰州大学第一医院内分泌科住院的T2DM甲状腺功能正常患者1305例。采用甲状腺反馈分位数指数（PTFQI）、甲状腺反馈分位数指数（TFQI）、促甲状腺激素指数（TSHI）、血清游离三碘甲状腺原氨酸与游离甲状腺素（FT3/FT4）比值、促甲状腺素甲状腺素抵抗指数（TT4RI）等指标评价甲状腺激素敏感性。根据五项指标的四分位数水平将患者再分为四组（q1 ~ q1）。采用二元logistic回归和限制性三次样条（RCS）分析甲状腺激素敏感性与DN的相关性。结果：DN组PTFQI、TFQI、TSHI水平均高于非DN组[0.04(-0.21,0.31)vs -0.003(-0.27, 0.25), 0.05(-0.20, 0.30) vs 0.006(-0.26, 0.25), 2.54±0.52 vs 2.47±0.51，均为PPP非线性>0.05]。随着PTFQI、TFQI、TSHI水平的升高，FT3/FT4水平的降低，DN患病率和尿白蛋白-肌酐（UACR）水平呈上升趋势（p趋势试验）结论：甲状腺功能正常的T2DM患者中，甲状腺激素敏感性受损与DN有关，UACR水平升高，eGFR水平降低。
The Correlation Between Impaired Thyroid Hormone Sensitivity and Diabetic Nephropathy in Euthyroid Patients with Type 2 Diabetes Mellitus.
Purpose: To investigate the association between impaired thyroid hormone sensitivity and diabetic nephropathy (DN) in euthyroid patients with type 2 diabetes mellitus (T2DM).
Methods: 1305 euthyroid patients with T2DM who were hospitalized in the Endocrinology Department of the First Hospital of Lanzhou University between July 2021 and August 2023 were selected. Several indices, such as the parameters thyroid feedback quantile index (PTFQI), thyroid feedback quantile index (TFQI), thyroid stimulating hormone index (TSHI), serum-free triiodothyronine to free thyroxine (FT3/FT4) ratio, and thyrotropin thyroxine resistance index (TT4RI) to evaluate thyroid hormone sensitivity were used. The patients were subdivided into four groups (Q1 to Q4) based on the quartile levels of the five indices. The correlation between thyroid hormone sensitivity and DN was analyzed by binary logistic regression and restricted cubic spline (RCS) analysis.
Results: The levels of PTFQI, TFQI, and TSHI in the DN group were higher than those in the Non-DN group [0.04(-0.21, 0.31) vs -0.003(-0.27, 0.25), 0.05(-0.20, 0.30) vs 0.006(-0.26, 0.25), 2.54±0.52 vs 2.47±0.51, all P<0.05], while the FT3/FT4 levels were decreased in the DN group (0.40±0.07 vs 0.42±0.07, P<0.05). Multivariate logistic regression analysis showed that the increase in PTFQI and TFQI levels was positively correlated with DN [OR=1.518, 95% CI(1.074, 2.145) and OR=1.546, 95% CI(1.084, 2.204)]. RCS showed a linear dose-response relationship between PTFQI, TFQI, TSHI, FT3/FT4, TT4RI, and the tendency of DN (all Pnon-linear>0.05). As the levels of PTFQI, TFQI, and TSHI increased, and the FT3/FT4 levels decreased, the prevalence of DN and the urinary albumin-to-creatinine (UACR) level showed an upward trend (all Ptrend test <0.05), while the estimated glomerular filtration rate (eGFR) level showed a downward trend (all Ptrend test <0.05).
Conclusion: Among euthyroid patients with T2DM, impaired thyroid hormone sensitivity is associated with DN, as well as elevated UACR levels and decreased eGFR levels.
期刊介绍：
An international, peer-reviewed, open access, online journal. The journal is committed to the rapid publication of the latest laboratory and clinical findings in the fields of diabetes, metabolic syndrome and obesity research. Original research, review, case reports, hypothesis formation, expert opinion and commentaries are all considered for publication.
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