ASSOCIATION BETWEEN THYROID HORMONE LEVELS AND ADVANCED LIVER FIBROSIS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS AND...

The degree of hepatic fibrosis is a significant predictor of mortality in patients with non-alcoholic fatty liver disease (NAFLD) and type 2 diabetic mellitus (T2DM). This study aims to evaluate the relationship between blood thyroid hormone levels and advanced liver fibrosis in patients with non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus.

A cross-sectional study involving 350 patients with Type 2 Diabetes Mellitus (T2DM) was carried out at the Ibn-Khaldon Diabetic Medical Center in Port-Sudan City, Red Sea State, Sudan, between December 2024 and February 2025. Of these, 140 patients had T2DM without NAFLD, and 210 patients had NAFLD, of whom 114 had progressive liver fibrosis and 96 did not. Following a 12-hour fast, laboratory tests were conducted. A Mindray A88 biochemical analyzer was used to examine blood samples for lipid profiles (total cholesterol, triglycerides, HDL, and LDL) and liver function indicators (AST, ALT, and albumin). FT3, FT4, TT3, TT4, and TSH levels were measured using a Finecare Plus 114 chemical analyzer to evaluate thyroid function. Non-alcoholic fatty liver disease (NAFLD) was diagnosed by abdominal ultrasound imaging; an NFS of more than 0.676 denoted growing hepatic fibrosis.

BMI, ALT, AST, TG, TC, and TT3 were significantly greater in T2DM with NAFLD, while HDL-C, FT3, FT4, and TT4 were significantly decreased (P < 0.05). relative to T2DM in the absence of NAFLD. Levels of FT3, FT4, TT3 ALT, TC, TG, PLT, ALB, TT4, and BMI were considerably lower in T2DM patients with increasing liver fibrosis than in those without the condition (p<0.05). There was no significant difference in HDL-C, LDL-, AST, or TSH levels between the two groups (P>0.05). TT3, TT4, and TSH levels did not positively correlate with NAFLD (p=0.409, 0.352, 0.081). Model 3 included adjustments for age, BMI, TG, and HDL. It was evident from the study's results that FT3 and NAFLD were negatively correlated (p=0.004).

Significant association between liver fibrosis in those with type 2 diabetes and abnormal thyroid hormone levels. There is a negative correlation between the prevalence of advanced fibrosis and cases of T2DM and NAFLD, and a low FT3 level is an independent risk factor for advanced fibrosis.