性别相关和甲状腺相关激素与 2 型糖尿病患者代谢功能障碍相关脂肪性肝病风险的相关性。
Associations of sex-related and thyroid-related hormones with risk of metabolic dysfunction-associated fatty liver disease in T2DM patients.
机构信息
Department of Gynecology, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, China.
Xiamen Clinical Research Center for Cancer Therapy, Xiamen, China.
出版信息
BMC Endocr Disord. 2024 Jun 7;24(1):84. doi: 10.1186/s12902-024-01618-0.
BACKGROUND
We aimed to examine sex-specific associations between sex- and thyroid-related hormones and the risk of metabolic dysfunction-associated fatty liver disease (MAFLD) in patients with type 2 diabetes mellitus (T2DM).
METHODS
Cross-sectional analyses of baseline information from an ongoing cohort of 432 T2DM patients (185 women and 247 men) in Xiamen, China were conducted. Plasma sex-related hormones, including estradiol (E2), follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), progesterone, and total testosterone (TT), and thyroid-related hormones, including free triiodothyronine (FT3), free thyroxine (FT4), thyroid-stimulating hormone (TSH), and parathyroid hormone (PTH), were measured using chemiluminescent immunoassays. MAFLD was defined as the presence of hepatic steatosis (diagnosed by either hepatic ultrasonography scanning or fatty liver index (FLI) score > 60) since all subjects had T2DM in the present study.
RESULTS
Prevalence of MAFLD was 65.6% in men and 61.1% in women with T2DM (P = 0.335). For men, those with MAFLD showed significantly decreased levels of FSH (median (interquartile range (IQR)):7.2 (4.9-11.1) vs. 9.8 (7.1-12.4) mIU/ml) and TT (13.2 (10.4-16.5) vs. 16.7 (12.8-21.6) nmol/L) as well as increased level of FT3 (mean ± standard deviation (SD):4.63 ± 0.68 vs. 4.39 ± 0.85 pmol/L) than those without MAFLD (all p-values < 0.05). After adjusting for potential confounding factors, FSH and LH were negative, while progesterone was positively associated with the risk of MAFLD in men, and the adjusted odds ratios (ORs) (95% confidence intervals (CIs)) were 0.919 (0.856-0.986), 0.888 (0.802-0.983), and 8.069 (2.019-32.258) (all p-values < 0.05), respectively. In women, there was no statistically significant association between sex- or thyroid-related hormones and the risk of MAFLD.
CONCLUSION
FSH and LH levels were negative, whereas progesterone was positively associated with the risk of MAFLD in men with T2DM. Screening for MAFLD and monitoring sex-related hormones are important for T2DM patients, especially in men.
背景
我们旨在研究 2 型糖尿病（T2DM）患者中性别和甲状腺相关激素与代谢功能障碍相关脂肪性肝病（MAFLD）风险之间的性别特异性关联。
方法
对来自中国厦门正在进行的 432 例 T2DM 患者（185 名女性和 247 名男性）的基线信息进行横断面分析。使用化学发光免疫测定法测量血浆性激素，包括雌二醇（E2）、卵泡刺激素（FSH）、黄体生成素（LH）、催乳素（PRL）、孕酮和总睾酮（TT），以及甲状腺相关激素，包括游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）、促甲状腺激素（TSH）和甲状旁腺激素（PTH）。在本研究中，所有受试者均患有 T2DM，因此 MAFLD 定义为存在肝脂肪变性（通过肝脏超声扫描或脂肪肝指数（FLI）评分 > 60 诊断）。
结果
男性 MAFLD 的患病率为 65.6%，女性为 61.1%（P = 0.335）。与无 MAFLD 者相比，男性 MAFLD 者 FSH（中位数（四分位距（IQR））：7.2（4.9-11.1）比 9.8（7.1-12.4）mIU/ml）和 TT（13.2（10.4-16.5）比 16.7（12.8-21.6）nmol/L）水平显著降低，FT3 水平升高（平均值 ± 标准差（SD）：4.63 ± 0.68 比 4.39 ± 0.85 pmol/L）（所有 P 值均<0.05）。在调整了潜在混杂因素后，FSH 和 LH 呈负相关，而孕激素与男性 MAFLD 的风险呈正相关，调整后的比值比（OR）（95%置信区间（CI））分别为 0.919（0.856-0.986）、0.888（0.802-0.983）和 8.069（2.019-32.258）（均 P 值<0.05）。在女性中，性别或甲状腺相关激素与 MAFLD 的风险之间没有统计学意义的关联。
结论
在 T2DM 男性中，FSH 和 LH 水平呈负相关，而孕激素与 MAFLD 的风险呈正相关。筛查 MAFLD 和监测性激素对 T2DM 患者很重要，尤其是男性。
Zotero 插件