Department of Endocrinology, Geriatrics Center, The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei, 230001, Anhui, China.
BMC Endocr Disord. 2022 May 31;22(1):144. doi: 10.1186/s12902-022-01050-2.
The objective of this study is to retrospectively analyze the correlation between the thyroid hormones and nonalcoholic fatty liver disease (NAFLD) in type 2 diabetes mellitus (T2DM) patients with normal thyroid function.
Totally 586 T2DM patients with normal thyroid function participated in this research and were divided into T2DM without NAFLD (240 cases) group and T2DM with NAFLD (346 cases) group. The NAFLD fibrosis score (NFS) > 0.676 was defined as progressive liver fibrosis and used to categorize the patients into T2DM without progressive liver fibrosis group (493 cases) and T2DM with progressive liver fibrosis group (93 cases).
The results indicated that the levels of free triiodothyronine (FT3), total triiodomethylamine (TT3) and FT3/free thyroxine ratio (FT3/FT4) were significantly higher while the FT4 level was lower in T2DM with NAFLD group than that in T2DM without NAFLD group (p < 0.05). The levels of FT3, FT4, TT3 and TT4 in patients with progressive liver fibrosis were significantly lower in patients with progressive liver fibrosis than that in patients without progressive liver fibrosis (p < 0.05). Logistic regression analysis showed a positive connection between FT3/FT4 ratio and NAFLD (p = 0.038), a negative relationship between FT4 level and NAFLD (p = 0.026), between the levels of FT4, TT3 and total thyroxine (TT4) and the risk of progressive hepatic fibrosis (p = 0.022, p = 0.007, p = 0.046).
There is a certain correlation between thyroid hormone levels and NAFLD in T2DM patients, suggesting that the assessment of thyroid hormone levels in T2DM patients with normal thyroid function could be helpful in the prevention and treatment of NAFLD.
本研究旨在回顾性分析甲状腺功能正常的 2 型糖尿病(T2DM)患者甲状腺激素与非酒精性脂肪性肝病(NAFLD)之间的相关性。
共纳入 586 例甲状腺功能正常的 T2DM 患者,分为 T2DM 无 NAFLD(240 例)组和 T2DM 伴 NAFLD(346 例)组。NAFLD 纤维化评分(NFS)>0.676 定义为进展性肝纤维化,用于将患者分为 T2DM 无进展性肝纤维化组(493 例)和 T2DM 进展性肝纤维化组(93 例)。
结果表明,T2DM 伴 NAFLD 组游离三碘甲状腺原氨酸(FT3)、总三碘甲状腺原氨酸(TT3)和 FT3/游离甲状腺素比值(FT3/FT4)水平明显升高,FT4 水平明显降低(p<0.05)。进展性肝纤维化患者 FT3、FT4、TT3 和 TT4 水平明显低于无进展性肝纤维化患者(p<0.05)。Logistic 回归分析显示,FT3/FT4 比值与 NAFLD 呈正相关(p=0.038),FT4 水平与 NAFLD 呈负相关(p=0.026),FT4、TT3 和总甲状腺素(TT4)水平与进展性肝纤维化的风险呈负相关(p=0.022,p=0.007,p=0.046)。
甲状腺激素水平与 T2DM 患者的 NAFLD 之间存在一定的相关性,提示评估甲状腺功能正常的 T2DM 患者的甲状腺激素水平有助于预防和治疗 NAFLD。