甲状腺功能略高于正常水平可预测中年及老年甲状腺功能正常者发生非酒精性脂肪性肝病。
High-Normal Thyroid Function Predicts Incident Nonalcoholic Fatty Liver Disease Among Middle-Aged and Older Euthyroid Subjects.
作者信息
Gu Yeqing, Wu Xiaohui, Zhang Qing, Liu Li, Meng Ge, Wu Hongmei, Zhang Shunming, Wang Yawen, Zhang Tingjing, Wang Xuena, Sun Shaomei, Wang Xing, Zhou Ming, Jia Qiyu, Song Kun, Niu Kaijun
机构信息
Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China.
Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, China.
出版信息
J Gerontol A Biol Sci Med Sci. 2022 Jan 7;77(1):197-203. doi: 10.1093/gerona/glab037.
BACKGROUND
Thyroid hormones (THs) influence hepatic lipid homeostasis through multiple pathways, suggesting that THs may predict the risk of nonalcoholic fatty liver disease (NAFLD). However, prospective studies on the association between THs levels and incident NAFLD in euthyroid subjects are limited. This prospective cohort study aimed to explore whether THs were associated with the development of NAFLD in middle-aged and older euthyroid subjects.
METHOD
A total of 6462 subjects without baseline NAFLD were included in the cohort study (~6-year follow-up period, median: 4.2 years). Chemiluminescence immunoassay was used to measure serum free triiodothyronine (FT3), free thyroxine (FT4), and thyroid-stimulating hormone (TSH), and NAFLD was diagnosed by abdominal ultrasonography. Multivariable Cox proportional hazards regression models were used to assess the association between baseline THs, TSH, and the risk of NAFLD.
RESULTS
During the follow-up period, 1675 subjects developed NAFLD. The incidence rate of NAFLD was 85.0 per 1000 person-years. Compared with the lowest FT3, FT4, and TSH quartiles, the multivariable-adjusted hazard ratios (95% confidence interval) of incident NAFLD for highest quartiles were 1.30 (1.12, 1.51), 1.07 (0.93, 1.23), and 0.82 (0.71, 0.95) (p < .001, p = .56, p = .01, respectively).
CONCLUSIONS
In middle-aged and older euthyroid subjects, high-normal FT3 and low-normal TSH are independently associated with a higher incidence of NAFLD.
背景
甲状腺激素（THs）通过多种途径影响肝脏脂质稳态，提示THs可能预测非酒精性脂肪性肝病（NAFLD）的风险。然而，关于甲状腺功能正常的受试者中THs水平与新发NAFLD之间关联的前瞻性研究有限。这项前瞻性队列研究旨在探讨THs是否与中年及老年甲状腺功能正常的受试者中NAFLD的发生有关。
方法
队列研究共纳入6462名无基线NAFLD的受试者（随访约6年，中位数：4.2年）。采用化学发光免疫分析法测定血清游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）和促甲状腺激素（TSH），并通过腹部超声诊断NAFLD。使用多变量Cox比例风险回归模型评估基线THs、TSH与NAFLD风险之间的关联。
结果
在随访期间，1675名受试者发生了NAFLD。NAFLD的发病率为每1000人年85.0例。与FT3、FT4和TSH最低四分位数相比，最高四分位数的新发NAFLD的多变量调整风险比（95%置信区间）分别为1.30（1.12，1.51）、1.07（0.93，1.23）和0.82（0.71，0.95）（p <.001、p = 0.56、p = 0.01）。
结论
在中年及老年甲状腺功能正常的受试者中，FT3处于高正常水平和TSH处于低正常水平与NAFLD的较高发病率独立相关。
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