2型糖尿病患者合并非酒精性脂肪性肝病与甲状腺功能的相关性研究

Relationship between non-alcoholic fatty liver disease and thyroid function in patients with type 2 diabetes

目的探讨住院T2DM患者合并非酒精性脂肪性肝病(NAFLD)的患病率及与甲状腺功能的相关性研究。方法选取2016年7月至2018年6月于我院内分泌科住院的T2DM患者538例,根据肝脏超声检查分为T2DM合并NAFLD组(NAFLD,n=247)和单纯T2DM组(T2DM,n=291)。各组检测HbA1c、FPG、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)和促甲状腺激素(TSH)等。结果住院T2DM患者NAFLD患病率为45. 9%,男性高于女性(51. 4%vs 39. 4%,P<0. 01)。NAFLD组TSH高于T2DM组[2. 74(1. 78,4. 41)vs 2. 35(1. 45,3. 54)mIU/L,P<0. 05],两组FT3和FT4水平差异无统计学意义(P>0. 05)。根据TSH水平分组,与TSH<2. 5 mIU/L组比较,2. 5~4. 0 m IU/L组和>4. 0 mIU/L组NAFLD患病率、ALT和TG升高(P<0. 05);与2. 5~4. 0mIU/L组比较,>4. 0 mIU/L组ALT升高(P<0. 05)。Logistic回归分析显示,TSH、TG、ALT、HOMA-IR和BMI是NAFLD的影响因素(P<0. 05)。结论 T2DM患者合并NAFLD与TSH水平密切相关。

Objective To investigate the prevalence of non-alcoholic fatty liver disease(NAFLD) in hospitalized patients with type 2 diabetes mellitus(T2 DM)and its correlation with thyroid function.Methods538 T2DM patients were divided into T2DM with NAFLD group(NAFLD,n=247)and T2DM without NAFLD group(T2DM,n=291). NAFLD was diagnosed on the basis of typical ultrasonography. Laboratory assessments including HbA1 c,fasting plasma glucose(FPG),FT3,FT4 and TSH were detected.Results which was higher in male than that in female(51. 4% vs 39. 4%,P<0. 05). The levels of TSH in NAFLD group was higher than that of T2DM group[2. 74(1. 78,4. 41)vs 2. 35(1. 45,3. 54)mIU/L,P<0. 05].There was no significant difference in FT3 or FT4 level between NAFLD and T2 DM groups. Compared with TSH < 2. 5 mIU/L group,the proportion of fatty liver,ALT and TG levels in TSH>4. 0 mIU/L group and TSH 2. 5~4. 0 mIU/L group were significantly higher(P<0. 05). The ALT level in TSH >4. 0 mIU/L group was significantly higher than that in TSH<2. 5~4. 0 mIU/L group(P<0. 05). Logisitc regression analysis showed that TSH,TG,ALT,HOMA-IR and BMI were independently correlated with NAFLD(P<0. 05).ConclusionThe combination of NAFLD in T2DM patients was significantly correlated with TSH.