Thyroid function is associated with non-alcoholic fatty liver disease in chronic hepatitis B-infected subjects
Thyroid function is associated with non-alcoholic fatty liver disease in chronic hepatitis B-infected subjects
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甲状腺功能与慢性乙型肝炎感染者的非酒精性脂肪肝相关
DOI：
10.1111/jgh.12998
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发表时间：
2015-12-01
影响因子：
4.1
通讯作者：
Fan, Jian-Gao
中科院分区：
文献类型：
--
作者：
Ding, Wen-Jin;Wang, Man-Man;Fan, Jian-Gao
背景和目标：慢性B型肝炎（CH B）感染患者甲状腺功能与非酒精性脂肪肝（NAFLD）之间的关系尚不清楚。方法：回顾性分析2007年1月至2011年12月期间接受肝活检和血清甲状腺功能检测的慢性乙型肝炎初治患者的甲状腺功能异常的患病率及其与NAFLD的关系。结果：1154例非酒精性慢性乙型肝炎患者中，NAFLD患者270例（23.39%），其中以轻度脂肪变性最多（88.5%）。甲亢和甲减（包括亚临床和显性）的患病率分别为1.56%和1.64%，在NAFLD组和非NAFLD组中的患病率相似（分别为1.85%和1.47%，1.48%和1.69%，均P > 0.05）。NAFLD患者血清促甲状腺激素（TSH）水平显著高于非NAFLD患者（2.22 ± 2.13 vs1.61 ± 1.20mIU/L，P < 0.05）。调整年龄和性别后，TSH水平升高与脂肪变性的几率增加（比值比1.54，95%置信区间1.049-2.271），而不是病毒因素和肝脏炎症和fibrosis.Conclusions：甲状腺功能障碍是不常见的慢性乙型肝炎感染患者，甲状腺功能减退症的患病率在慢性乙型肝炎个体或无NAFLD是相似的。然而，在正常范围内血清TSH浓度升高是CHB患者肝脂肪变性的重要预测因素。
Background and Aims: Associations between thyroid function and non-alcoholic fatty liver disease (NAFLD) are unknown in chronic hepatitis B (CHB)-infected patients. Thus, the aim of the study was to investigate the prevalence of thyroid dysfunction and its relationship with NAFLD in CHB.Methods: Consecutive naive CHB infected patients that had undergone liver biopsy and serum thyroid function tests between January 2007 and December 2011 were retrospective analyzed. NAFLD was diagnosed as at least 5% biopsy-proven hepatic steatosis without significant alcohol consumption.Results: A total of 1154 non-alcoholics with CHB were included, 270 (23.39%) patients were found to have NAFLD, most of them (88.5%) with mild steatosis. The prevalence of hyperthyroidism and hypothyroidism (including subclinical and overt) was 1.56% and 1.64%, respectively, both with similar rates in patients with and without NAFLD (1.85% vs 1.47%, 1.48% vs 1.69%, respectively, both P > 0.05). The serum thyroid-stimulating hormone (TSH) level in NAFLD patients was significantly higher than that in patients without NAFLD (2.22+/- 2.13 vs 1.61+/- 1.20 mIU/L, P < 0.05). After adjustment for age and gender, the elevated TSH level was associated with increased odds of having steatosis (odds ratio1.54, 95% confidence interval 1.049-2.271) instead of viral factors and hepatic inflammation and fibrosis.Conclusions: Thyroid dysfunction is not common in CHB-infected patients, and the prevalence of hypothyroidism in CHB individuals with or without NAFLD is similar. However, increased serum TSH concentration at the normal range is a significant predictor of hepatic steatosis in patients with CHB.