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目的 探讨促甲状腺激素(TSH)正常的2型糖尿病(T2DM)患者低三碘甲状腺原氨酸(T3)综合征与微量白蛋白尿发生的相关性.方法 392例T2DM患者根据24-h尿白蛋白排泄率(AER)分为两组:正常白蛋白尿组(A组,253例,AER＜30 mg/24 h)、微量白蛋白尿组(B组,139例,30 mg/24 h≤AER＜300 mg/24 h).检测血浆ALT、AST、TC、TG、HDL-C、LDL-C、BUN、SCr、HbA1c、FT3、FT4和TSH水平及24-h尿白蛋白定量,分析甲状腺功能和微量白蛋白尿的相关性.结果 与A组相比,B组FT3水平较低[(4.33±0.60) pmol/L vs.(4.54±0.52) pmol/L](P＜0.01),低T3综合征发生率较高(9.35％ vs.2.85％) (P＜0.01).Spearman线性相关分析显示,24-h尿白蛋白与FT3呈负相关(rs=-0.163,P＜0.01).多元线性回归分析结果显示,FT3与24-h尿白蛋白呈负相关(β=-0.148,P＜0.05).低T3综合征组24-h尿白蛋白和微量白蛋白尿发生率高于正常甲状腺功能组[(82.82±93.38) mg/24 h vs.(37.53±52.47) mg/24 h和65.00％ vs.46.32％](P＜0.01).结论 TSH正常的T2DM患者低FT3水平及低T3综合征与微量白蛋白尿发生密切相关.“,”Objective To investigate the correlation between low-triiodothyronine (T3) syndrome and microalbuminuria in type 2 diabetes mellitus (T2DM) patients with normal thyroid-stimulating hormone(TSH).Methods Ninety-two patients with T2DM were divided into two groups of A(AER＜30 mg/24 h,253 cases) and B(30 mg/24 h≤AER＜300 mg/24 h,139 cases).The ALT,AST,TC,TG,HDL-C,LDL-C,BUN,SCr,HbA1c,FT3,FT4,TSH and 24-h urinary albumin were measured.The correlation between thyroid function and microalbuminuria was analyzed.Results Compared with group A,the level of FT3 in group B was lower[(4.33±0.60) pmol/L vs.(4.54± 0.52) pmol/L] (P＜0.01) and the incidence of low T3 syndrome was higher(9.35％ vs.2.85％) (P＜0.01).Spearman linear correlation analysis showed that 24-h urinary albumin was negatively correlated with FT3 (rs =-0.163,P＜0.01).Multiple linear regression analysis showed that FT3 was negatively correlated with 24-h urinary albumin (β =-0.148,P＜0.05).The level of 24-h urine albumin and the incidence of microalbuminuria were higher in the patients with low T3 syndrome than those with normal thyroid function[(82.82± 93.38) mg/24 h vs.(37.53 ± 52.47) mg/24 h and 65.00％ vs.46.32％] (P＜0.01).Conclusion Low FT3 levels and low T3 syndrome are closely correlated with microalbuminuria in T2DM patients with normal TSH.