Zhang Xuanxuan, Jiang Meijuan, Zhu Wei, Xu Shouxing, Wang Wenqian, Ying Bin, Chen Xiaoting, Zhang Shanshan, Pan Jianlian, Zhang Kai, Tacke Frank, Yang Ju Dong, Chen Jian
Department of Ultrasound in Medicine, the Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu, China.
Department of Ultrasound in Medicine, Women's Hospital School of Medicine Zhejiang University, Hangzhou, China.
Gland Surg. 2025 Apr 30;14(4):726-737. doi: 10.21037/gs-2025-62. Epub 2025 Apr 16.
Thyroid hormones impact on metabolic homeostasis, and low thyroid hormone levels, both systemically and hepatically, have been linked to hepatic steatosis. However, prior studies in this area often lacked quantification of steatosis. Ultrasound attenuation analysis (USAT) is a novel imaging technique for hepatic steatosis detection based on the attenuation coefficient. Our objective in this study was to assess the correlation between thyroid hormone levels and hepatic steatosis via the USAT attenuation coefficient in metabolic dysfunction-associated steatotic liver disease (MASLD) and chronic hepatitis B (CHB) groups.
This retrospective study included 86 patients with CHB and 45 patients with suspicious MASLD. Demographic information, biochemical parameters, and thyroid hormone levels were analyzed. The severity of steatosis in MASLD or CHB was assessed by USAT.
Patients in the MASLD group were more likely to have type 2 diabetes mellitus (T2DM) and hypertension as compared with those in the CHB group (P<0.05). The levels of triiodothyronine (T3) were significantly lower and the platelet counts higher in the MASLD group than in the CHB group (P<0.05). The body mass index (BMI), distance from skin to capsule, USAT values, and alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels in patients with hepatic steatosis were significantly higher than those in patients without hepatic steatosis (P<0.05). Logistic regression analysis indicated a correlation between free triiodothyronine (FT3) level and hepatic steatosis (P=0.04) as well as between free thyroxine (FT4) level and hepatic steatosis (P=0.045).
Quantitative USAT evaluation suggested that hepatic steatosis is strongly correlated with thyroid hormones. These data emphasize the relevance of thyroid hormones for regulating hepatic lipid accumulation and metabolism.
甲状腺激素影响代谢稳态,全身及肝脏甲状腺激素水平降低均与肝脂肪变性有关。然而,该领域既往研究往往缺乏对脂肪变性的量化。超声衰减分析(USAT)是一种基于衰减系数检测肝脂肪变性的新型成像技术。我们在本研究中的目的是通过USAT衰减系数评估代谢功能障碍相关脂肪性肝病(MASLD)和慢性乙型肝炎(CHB)组中甲状腺激素水平与肝脂肪变性之间的相关性。
这项回顾性研究纳入了86例CHB患者和45例疑似MASLD患者。分析了人口统计学信息、生化参数和甲状腺激素水平。通过USAT评估MASLD或CHB中脂肪变性的严重程度。
与CHB组患者相比,MASLD组患者更易患2型糖尿病(T2DM)和高血压(P<0.05)。MASLD组的三碘甲状腺原氨酸(T3)水平显著低于CHB组,血小板计数则高于CHB组(P<0.05)。肝脂肪变性患者的体重指数(BMI)、皮肤至包膜距离、USAT值以及丙氨酸氨基转移酶(ALT)和天冬氨酸氨基转移酶(AST)水平显著高于无肝脂肪变性患者(P<0.05)。逻辑回归分析表明,游离三碘甲状腺原氨酸(FT3)水平与肝脂肪变性之间存在相关性(P=0.04),游离甲状腺素(FT4)水平与肝脂肪变性之间也存在相关性(P=0.045)。
定量USAT评估表明,肝脂肪变性与甲状腺激素密切相关。这些数据强调了甲状腺激素在调节肝脏脂质蓄积和代谢方面的相关性。