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首页> 外文期刊>Kidney >Relation Between Thyroid Hormones and Insulin Resistance in Hemodialysis Patients
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Relation Between Thyroid Hormones and Insulin Resistance in Hemodialysis Patients

机译：血液透析患者甲状腺激素与胰岛素抵抗的关系

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Insulin resistance (IR) is a common problem in patients with ESRD on regular HD, and it is related to many complications, including cardiovascular complications, the major killer in these patients. Disorders of thyroid function are common in patients with ESRD. Many factors have been claimed to contribute to IR in HD patients. Our aim is to study the relations between thyroid hormones and IR in HD patients for better understanding and management of IR. The study involved 35 patients with ESRD under regular HD (group 1) and 20 normal control subjects (group 2). All of them underwent complete history taking and clinical examination: biochemical and hematological, thyroid hormones TSH, free T3 (FT3) and free T4 (FT4), and insulin resistance using the homeostasis model assessment (HOMA-IR). Patients with DM and those with known thyroid disorders were excluded from the study. Comparing HD patients and normal control subjects shows significant differences as regards FT3 (p = 0.04) 33.58 ± 12.14 vs. 40.63 ± 11.27 pg/l, respectively; TSH (p = 0.03) 3.29 ± 3.83 vs. 1.80 ± 0.88 mu/l, respectively; fasting insulin level (p < 0.001) 30.1 ± 6.05 vs. 10.68 ± 2.77 mu/ml, respectively; HOMA (p < 0.001) 6.72 ± 1.41 vs. 2.4 ± 0.67, respectively. There is no significant difference as regards FT4 (p = 0.36) 15.17 ± 6.72 vs. 16.35 ± 2.66 pmol/l, respectively. Bivariate correlation in HD patients shows HOMA IR correlates with FT3 (p < 0.001), FT4 (p < 0.001), TSH (p < 0.001), HDL (p < 0.001), and hematocrit (p < 0.001). No correlations were found with BMI, age, total cholesterol, LDL, or triglycerides. Linear regression analysis showed HOMA-IR was independently determined by HDL (p = 0.04), hematocrit (p = 0.02), and TSH (p = 0.008). IR is very common in HD patients. There is a close correlation between IR and thyroid hormones. TSH, HDL, and hematocrit levels independently determine IR. Regular follow-up of these factors is necessary for proper management of IR.
机译：胰岛素抵抗（IR）是定期接受HD检查的ESRD患者的常见问题，并且与许多并发症有关，包括心血管并发症，是这些患者的主要杀手。 ESRD患者常见甲状腺功能异常。据称有许多因素可导致HD患者的IR。我们的目的是研究HD患者的甲状腺激素与IR之间的关系，以更好地了解和管理IR。这项研究涉及35名常规HD下的ESRD患者（第1组）和20名正常对照受试者（第2组）。他们都接受了完整的病史和临​​床检查：生化和血液学，甲状腺激素TSH，游离T3（FT3）和游离T4（FT4），以及使用稳态模型评估（HOMA-IR）的胰岛素抵抗。 DM患者和已知甲状腺疾病患者被排除在研究之外。 HD患者和正常对照组的比较显示FT3（p = 0.04）分别为33.58±12.14和40.63±11.27 pg / l的显着差异； TSH（p = 0.03）分别为3.29±3.83和1.80±0.88 mu / l;空腹胰岛素水平（p <0.001）分别为30.1±6.05和10.68±2.77 mu / ml; HOMA（p <0.001）分别为6.72±1.41和2.4±0.67。 FT4（p = 0.36）分别为15.17±6.72和16.35±2.66 pmol / l，无显着差异。 HD患者的双变量相关性显示HOMA IR与FT3（p <0.001），FT4（p <0.001），TSH（p <0.001），HDL（p <0.001）和血细胞比容（p <0.001）相关。没有发现与BMI，年龄，总胆固醇，LDL或甘油三酸酯相关。线性回归分析显示，HOMA-IR由HDL（p = 0.04），血细胞比容（p = 0.02）和TSH（p = 0.008）独立确定。 IR在HD患者中非常普遍。 IR和甲状腺激素之间存在密切的相关性。 TSH，HDL和血细胞比容水平独立确定IR。这些因素的定期随访对于IR的正确管理是必要的。

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