三碘甲状腺原氨酸与脂肪性肝病的发生/转归相关：甲状腺功能正常的韩国人的纵向研究

Triiodothyronine Is Associated with Incidence/Resolution of Steatotic Liver Disease: Longitudinal Study in Euthyroid Korean.

作者信息

Kim Hye In, Kim Jun Young, Cho Jung Hwan, Han Ji Min, Suh Sunghwan, Bae Ji Cheol, Kim Tae Hyuk, Kim Sun Wook, Hahm Jong Ryeal, Chung Jae Hoon

机构信息

Division of Endocrinology and Metabolism, Department of Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.

Division of Gastroenterology, Department of Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.

出版信息

Endocrinol Metab (Seoul). 2025 Feb;40(1):135-145. doi: 10.3803/EnM.2024.2040. Epub 2024 Dec 4.

DOI:10.3803/EnM.2024.2040

PMID:39628268

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11898316/

Abstract

BACKGRUOUND

The positive relationship between triiodothyronine (T3) and steatotic liver disease (SLD) demonstrated only in crosssectional study. We aimed to evaluated whether total T3 (TT3) is associated with the development/resolution of SLD in longitudinal design.

METHODS

This retrospective, longitudinal, population-based cohort study included 1,665 South Korean euthyroid adults with ≥4 thyroid function test. We explored the impact of mean TT3 during follow-up on development/resolution of either SLD (diagnosed by ultrasound) or modified metabolic dysfunction-associated steatotic liver disease (MASLD) using Cox proportional hazards regression models.

RESULTS

During about median 5 years follow-up, 807/1,216 (66.3%) participants among participants without SLD at baseline developed SLD, and 253/318 (79.5%) participants among participants with SLD at baseline SLD resolved fatty liver. Mean TT3 rather than thyroid stimulating hormone or mean free thyroxine was significantly related with development (adjusted hazard ratio [HR], 1.01; 95% confidence interval [CI], 1.00 to 1.02; P=0.002) and resolution (adjusted HR, 0.97; 95% CI, 0.96 to 0.99; P=0.005) of SLD. Compared with low mean TT3 group, high mean TT3 group was positively associated with development of SLD (adjusted HR, 1.20; 95% CI, 1.05 to 1.38; P=0.008) and inversely associated with resolution of SLD (adjusted HR, 0.66; 95% CI, 0.51 to 0.85; P=0.001). The statistical significance remained for development (adjusted HR, 1.29; 95% CI, 1.10 to 1.51; P=0.001) and resolution (adjusted HR, 0.71; 95% CI, 0.54 to 0.94; P=0.018) of modified MASLD.

CONCLUSION

In Korean euthyroid adults, TT3 level was associated with development and resolution of either SLD or modified MASLD.

摘要

背景

三碘甲状腺原氨酸（T3）与脂肪性肝病（SLD）之间的正相关关系仅在横断面研究中得到证实。我们旨在通过纵向研究评估总T3（TT3）是否与SLD的发生/消退相关。

方法

这项回顾性、纵向、基于人群的队列研究纳入了1665名甲状腺功能正常的韩国成年人，他们至少进行了4次甲状腺功能测试。我们使用Cox比例风险回归模型探讨了随访期间平均TT3对SLD（通过超声诊断）或改良代谢功能障碍相关脂肪性肝病（MASLD）的发生/消退的影响。

结果

在大约5年的中位随访期间，基线时无SLD的参与者中有807/1216（66.3%）发生了SLD，基线时患有SLD的参与者中有253/318（79.5%）的SLD患者脂肪肝消退。平均TT3而非促甲状腺激素或平均游离甲状腺素与SLD的发生（调整后的风险比[HR]，1.01；95%置信区间[CI]，1.00至1.02；P = 0.002）和消退（调整后的HR，0.97；95%CI，0.96至0.99；P = 0.005）显著相关。与低平均TT3组相比，高平均TT3组与SLD的发生呈正相关（调整后的HR，1.20；95%CI，1.05至1.38；P = 0.008），与SLD的消退呈负相关（调整后的HR，0.66；95%CI，0.51至0.85；P = 0.001）。改良MASLD的发生（调整后的HR，1.29；95%CI，1.10至1.51；P = 0.001）和消退（调整后的HR，0.71；95%CI，0.54至0.94；P = 0.018）的统计学意义仍然存在。