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血尿酸与肌酐在甲状腺功能减退人群中的相关性研究

The Association Between Serum Uric Acid and Creatinine in Patients with Hypothyroidism

  • 摘要: 目的 分析甲状腺功能降低人群中高尿酸血症患病情况及尿酸与肌酐的关系。方法 选取在我院行健康体检的人群共计2 078例健康体检者作为研究对象,采用电化学发光免疫分析法测定血清促甲状腺素(TSH)、 游离甲状腺素(FT4)和游离三碘甲状腺原氨酸(FT3),采用尿酸酶紫外法测定血清尿酸(SUA) 水平。将体检人群分为甲状腺功能减退组(甲减组)、正常对照组和亚临床甲状腺功能减退组(亚临床甲减组) ,对各项检测指标进行组间比较并进行相关性分析,计算各组高尿酸血症的患病率。结果 根据甲功检测结果将受检者分为正常对照组(1 685例),甲减组(38例),亚临床甲减组(355例)。TSH水平甲减组>亚临床甲减组>正常对照组,3组间差异有统计学意义( P<0.0001);3组间FT3、FT4水平差异有统计学意义( P<0.0001)。SCr水平甲减组>亚临床甲减组>正常对照组,且3组间差异有统计学意义( P=0.005)。SUA水平甲减组>亚临床甲减组>正常对照组,且3组间比较差异有统计学意义( P=0.008)。<60岁受检者中高尿酸血症患病率男性均高于女性,且差异有统计学意义( P<0.0001),其中,50~59岁年龄段男性高尿酸血症患病率最高。≥60岁受检者男性的高尿酸血症患病率高于女性,但差异无统计学意义( P=0.09)。对性别进行校正后相关性分析显示,TSH与SUA和SCr水平无相关关系,FT4与SCr和SUA水平有相关性(r=-0.978, P=0.001;r=-0.599, P=0.012),FT3与SCr和SUA水平有相关性(r=-0.745, P=0.007;r=-0.457, P=0.034)。结论 甲状腺激素水平的降低可能导致血肌酐水平的升高,甲状腺功能降低人群中血肌酐水平的升高可能与血尿酸水平升高有关。

     

    Abstract: Objective To determine the relationship between serum uric acid (SUA) and creatinine (SCr) in patients with hypothyroidism. Methods A total of 2 078 people who took physical examinations in the West China Hospital ,Sichuan University in May 2014 participated in this study. Serum thyrotropin (TSH), free thyroxine (FT4) and free triiodothyronine (FT3) were detected by electrochemiluminescence. SUA was measured using uricase UV method. The participants were divided into three groups according to their thyroid function: hypothyroidism, subclinical hypothyroidism (SCH) and control. The prevalence of hyperuricemia in each group was estimated. Correlation analyses were performed for the serum indicators. Results There were 1 685 participants in the control group, 38 in the hypothyroidism group, and 355 in the subclinical hypothyroidism group. Hypothyroidism patients had significantly higher levels of TSH than those in the control and SCH groups. Significant differences in serum levels of FT3 and FT4 were found between the three groups. Higher levels of SCr ( P=0.005) and SUA ( P=0.008) were also found in hypothyroidism patients compared with those in the control and SCH groups. In those younger than 60 years, men were more likely to catch hyperuricemia than women, with 50-59 year old men having the highest prevalence of hyperuricemia. Higher prevalence of hyperuricemia in men (compared to women) was also found in those older than 60 years, but without statistical significance ( P=0.09). After correcting for gender, TSH showed no correlations with SUA (r=-0.01, P=0.648) and SCr (r=-0.02, P=0.284); FT4 showed negative correlations with SUA (r=-0.978, P=0.001) and SCr (r=-0.599, P=0.012); FT3 showed negative correlations with SUA (r=-0.745, P=0.007) and SCr (r=-0.457, P=0.034). Conclusion Reduced thyroid hormone levels may lead to elevated SCr levels. And elevated SCr levels may be associated with elevated levels of SUA in patients with hypothyroidism.

     

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