Objective:To analyze the clinical characteristics of nephrotic syndrome(NS)patients with thyroid dysfunction,and explore the independent influencing factors of thyroid dysfunction in NS patients,providing theoretical basis for clinical diagnosis and treatment.Methods:A total of 499 NS patients treated in Yichang Central People's Hospital from January 2015 to December 2021 were selected and divided into the normal thyroid function group(n=187)and the thyroid dysfunction group(n=312),patients were further subdivided into subclinical hypothyroidism group(n=112),clinical hypothyroidism group(n=86),and euthyroid sick syndrome(ESS)group(n=114).The demographic informations and laboratory indicators of different patient groups were compared.The relationship between TH or TSH levels and clinical markers were investigated.The factors influencing thyroid dysfunction in patients with NS were explored using univariate and multivariate Logistic regression analysis.Results:The incidence of thyroid dysfunction in NS patients was 62.53％(312/499).Significant differences were found in gender,length of hospital stay,24-hour urine protein quantitation(24 h-UTP),urea nitrogen(BUN),serum albumin(Alb),total cholesterol(CHOL),C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),free triiodothyronine(FT3),free thyroxine(FT4),and TSH between the normal thyroid function group and the thyroid dysfunction group(all P＜0.05).Levels of ESR and CHOL in the subclinical hypothyroidism group and clinical hypothyroidism group,as well as BUN levels in the ESS Group,were significantly higher compared to the normal thyroid function group(all P＜0.05).Conversely,the level of Alb in the subclinical hypothyroidism group,clinical hypothyroidism group,and ESS Group were significantly lower than those in the normal thyroid function group(all P＜0.05).Further Spearman correlation analysis showed that the levels of FT3,FT4,and TSH in NS patients with thyroid dysfunction were correlated with 24 h-UTP,Alb,BUN,Scr,etc(all P＜0.05).The results of multivariate Logistic regression analysis showed that increased serum Alb level(OR=0.866,95％CI:0.813,0.923)was an independent protective factor for thyroid dysfunction in NS patients,while female patients(OR=2.629,95％CI:1.603,4.312)and high levels of BUN(OR=1.099,95％CI:1.023,1.181)were independent risk factors for thyroid dysfunction(all P＜0.05).Conclusion:Female patients and high levels of BUN are considered as independent risk factors for thyroid dysfunction in NS patients,while increased serum Alb level is a protective factor.
维普
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