甲状腺疾病对德国非酒精性脂肪性肝病发病率的影响。
Impact of thyroid disorders on the incidence of non-alcoholic fatty liver disease in Germany.
机构信息
Department of Internal Medicine I, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany.
Cirrhosis Center Mainz (CCM), University Medical Center of the Johannes Gutenberg-University, Mainz, Germany.
出版信息
United European Gastroenterol J. 2021 Sep;9(7):829-836. doi: 10.1002/ueg2.12124. Epub 2021 Jul 20.
BACKGROUND
Studies investigating a potential association between hypothyroidism and non-alcoholic fatty liver disease (NAFLD) showed conflicting results and large-scale population-based data from Germany on this topic are currently missing.
OBJECTIVE
It was the aim of this analysis to investigate the impact of thyroid gland disorders on the prevalence of NAFLD in Germany.
METHODS
In this case-control study, using the German disease Analyzer database (IQVIA), NAFLD patients were matched to patients without NAFLD by age, sex, index year, treating physician, diabetes mellitus type II, and obesity. The main outcome of the study was an association between thyroid gland disorders (hypothyroidism, hyperthyroidism and autoimmune thyroiditis) and incident NAFLD and was evaluated using logistic regression analyses.
RESULTS
57,483 patients with NAFLD were matched to 57,483 patients without liver disease. Mean age of the cohort was 60.3 years (±14.1) and 52.3% were men. In regression analyses, hypothyroidism (OR 1.17, 95% CI 1.10 - 1.24, p < 0.001) as well as autoimmune thyroiditis (OR 1.53, 95% CI 1.35-1.73, p < 0.001) were associated with a higher risk of NAFLD. In contrast, hyperthyroidism was associated with a lower risk of NAFLD (OR 0.85, 95% CI 0.77-0.94, p < 0.001). The effect of hypothyroidism on the prevalence of NAFLD remained significant across men (OR 1.31, 95% CI 1.15-1.48) as well as women (OR 1.12, 95% CI 1.05-1.21).
CONCLUSION
Hypothyroidism seems to be a risk factor for incident NAFLD.
背景
研究表明，甲状腺功能减退症与非酒精性脂肪性肝病（NAFLD）之间可能存在关联，但结果存在争议，且目前德国缺乏关于这一主题的大规模人群数据。
目的
本分析旨在研究甲状腺疾病对德国 NAFLD 患病率的影响。
方法
在这项病例对照研究中，我们使用德国疾病分析数据库（IQVIA），通过年龄、性别、索引年、治疗医生、2 型糖尿病和肥胖症，将 NAFLD 患者与无 NAFLD 的患者相匹配。本研究的主要结局是甲状腺疾病（甲状腺功能减退症、甲状腺功能亢进症和自身免疫性甲状腺炎）与新发 NAFLD 之间的关联，并使用逻辑回归分析进行评估。
结果
57483 例 NAFLD 患者与 57483 例无肝病患者相匹配。队列的平均年龄为 60.3 岁（±14.1），其中 52.3%为男性。在回归分析中，甲状腺功能减退症（OR 1.17，95%CI 1.10-1.24，p<0.001）和自身免疫性甲状腺炎（OR 1.53，95%CI 1.35-1.73，p<0.001）与 NAFLD 的风险增加相关。相反，甲状腺功能亢进症与 NAFLD 的风险降低相关（OR 0.85，95%CI 0.77-0.94，p<0.001）。甲状腺功能减退症对 NAFLD 患病率的影响在男性（OR 1.31，95%CI 1.15-1.48）和女性（OR 1.12，95%CI 1.05-1.21）中均具有统计学意义。
结论
甲状腺功能减退症似乎是新发 NAFLD 的一个危险因素。
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