Non-alcoholic fatty liver disease across the spectrum of hypothyroidism
Non-alcoholic fatty liver disease across the spectrum of hypothyroidism
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DOI：
10.1016/j.jhep.2012.02.027
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发表时间：
2012-07-01
影响因子：
25.7
通讯作者：
Lee, Hyo-Suk
中科院分区：
文献类型：
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作者：
Chung, Goh Eun;Kim, Donghee;Lee, Hyo-Suk
背景和目标：本研究的目的是表征广谱甲状腺功能减退症和NAFLD.Methods之间的关系：一个横断面研究与4648健康体检对象（2324例甲减与年龄和性别匹配的对照组）进行。受试者分为亚临床[促甲状腺激素（TSH）≥ 4.1 mIU/L，游离甲状腺素（T-4）水平正常（0.7-1.8 ng/dl）]或明显甲状腺功能减退[游离T-4 < 0.7 ng/dl]。NAFLD是根据典型的超声检查结果和酒精摄入量低于20 g/天，在没有其他原因的肝脏diseases.Results的基础上诊断的：受试者的平均年龄为48.6 +/- 11.8岁，62.4%为女性。NAFLD与甲状腺功能减退症显著相关（30.2%患者vs. 19.5%对照组，p 33/25 IU/L），随着甲状腺功能减退症级别的增加而稳定增加（NAFLD，亚临床：29.9%和明显：36.3%; ALT异常，分别为20.1%和25.9%，p < 0.001）。多因素回归分析显示NAFLD与甲减有统计学意义（比值比（OR）1.38，95%置信区间（CI）1.17-1.62）和甲状腺功能减退等级呈剂量依赖性（OR 1.36，95% CI，1.16-1.61）。结论：亚临床甲减与NAFLD的发病有剂量依赖关系，即使在正常TSH水平的上限范围内也是如此。甲状腺功能减退症与NAFLD密切相关，独立于已知的代谢危险因素，证实了这两种疾病之间的相关临床关系。(C)2012年欧洲肝脏研究协会。Elsevier B. V.出版，保留所有权利。
Background & Aims: The aim of this study was to characterize the relationship between the broad spectrum of hypothyroidism and NAFLD.Methods: A cross-sectional study with 4648 health check-up subjects (2324 cases with hypothyroidism vs. age- and sex-matched controls) was conducted. The subjects were categorized as having either subclinical [thyroid-stimulating hormone (TSH) >= 4.1 mIU/L and normal free thyroixine (T-4) level (0.7-1.8 ng/dl)] or overt hypothyroidism [free T-4 < 0.7 ng/dl]. NAFLD was diagnosed on the basis of typical ultrasonographic findings, and alcohol consumption of less than 20 g/day in the absence of other causes of liver disease.Results: The mean age of the subjects was 48.6 +/- 11.8 years and 62.4% were female. NAFLD was significantly associated with hypothyroidism (30.2% patients vs. 19.5% control, p 33/25 IU/L) increased steadily with increasing grades of hypothyroidism (for NAFLD, subclinical: 29.9% and overt: 36.3%; for abnormal ALT, 20.1% and 25.9%, p < 0.001, respectively). Multivariate regression analysis showed that NAFLD was statistically significantly associated with hypothyroidism (odds ratio (OR) 1.38, 95% confidence interval (CI), 1.17-1.62) and the grade of hypothyroidism in a dose-dependent manner (OR 1.36, 95% CI, 1.16-1.61 in subclinical hypothyroidism and OR 1.71, 95% CI, 1.10-2.66 in overt hypothyroidism).Conclusions: Subclinical hypothyroidism, even in the range of upper normal TSH levels, was found to be related to NAFLD in a dose-dependent manner. Hypothyroidism is closely associated with NAFLD independently of known metabolic risk factors, confirming a relevant clinical relationship between these two diseases. (C) 2012 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.