甲状腺功能与非酒精性脂肪肝疾病的关联在最近出现的糖尿病中
Nina Saatmann1,2, Martin Schön1,2, Oana-Patricia Zaharia1,2,3
1Institute for Clinical Diabetology, German Diabetes Center, Leibniz Institute for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany.
甲状腺下部功能与非酒精性脂肪性肝病 (NAFLD) 在2型糖尿病 (T2D) 的风险有关,特别是在男性中. 这种联系是由胰岛素抵抗和体重介导的,但在1型糖尿病 (T1D) 中没有观察到.
科学领域:
- 内分泌学 在内分泌学.
- 代谢疾病 代谢疾病
- 肝病学 肝病学是一种肝病学.
背景情况:
- 非酒精性脂肪性肝病 (NAFLD) 是已知的2型糖尿病 (T2D) 的并发症.
- 在糖尿病人群中甲状腺功能和NAFLD之间的相互作用仍然不完全理解.
- 甲状腺功能低下症已经独立地与NAFLD相关.
研究的目的:
- 调查甲状腺激素 (自由甲状腺素 - fT4,甲状腺刺激激素 - TSH) 与最近出现糖尿病的个体中NAFLD之间的关联.
- 探索潜在的调解因素,如胰岛素敏感性和体重指数 (BMI).
主要方法:
- 分析来自德国糖尿病研究 (GDS) 的数据,这是一项前性队列研究.
- 包括最近出现的1型糖尿病 (T1D),T2D和对照组 (CON) 的参与者.
- 评估fT4,TSH,脂肪肝指数 (FLI),胰岛素敏感性 (通过Botnia紧固件测试) 和肝脏脂肪含量 (通过磁共振光谱在子队列中).
主要成果:
- 与对照组相比,T1D和T2D组的自由甲状腺素 (fT4) 水平都高于对照组,T1D和T2D之间没有显著差异.
- 在T2D中,较低的fT4水平与较高的FLI和较低的胰岛素敏感性相关,特别是在男性中.
- 这些相关性在调整胰岛素敏感性后失去了意义,这表明胰岛素抵抗是关键的调解者.
- 在调整之前,甲状腺刺激激素 (TSH) 与男性T2D患者的FLI呈阳性关联,后者消失了.
结论:
- 甲状腺功能,特别是较低的fT4,与T2D患者的NAFLD风险增加有关.
- 胰岛素抵抗和体重被认为是这种关系的重要媒介,特别是在男性中.
- 在T1D患者中,甲状腺功能和NAFLD之间没有显著的关联.
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