外周血尿酸、甲状腺激素水平与非酒精性脂肪性肝病发病风险的关系

Relationships between peripheral blood uric acid,thyroid hormone levels and the risk of non-alcoholic fatty liver disease

目的观察外周血尿酸、甲状腺激素水平与非酒精性脂肪性肝病(NAFLD)发病风险的关系。方法NAFLD患者139例(NAFLD组)、健康体检的健康成人54例(健康对照组),收集并比较两组患者的一般资料和实验室检查结果,包括性别、年龄、空腹血糖(FBS)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、γ-谷氨酰转移酶(γ-GT)、甘油三酯(TC)、总胆固醇(TG)、高密度脂蛋白胆固醇(HDL)、低密度脂蛋白胆固醇(LDL)、血清尿酸、血肌酐(Cr)、促甲状腺激素(TSH)、总T_(3)(TT_(3))、总甲状腺素(TT_(4))、游离T_(3)(FT_(3))、游离甲状腺素(FT_(4))。采用Logistic回归方法分析NAFLD发病的影响因素,并以血清尿酸水平416μmol/L为判定标准,采用Logistic回归方法分析血清尿酸水平正常、升高的NAFLD患者发病的影响因素。结果NAFLD组年龄、ALT、AST、γ-GT、TG、HDL、尿酸水平均高于健康对照组,而FT_(4)水平则低于健康对照组(P均<0.05)。ALT、HDL水平是NAFLD发病的独立影响因素。血清尿酸水平正常的NAFLD组年龄、FBS、ALT、AST、γ-GT、TG、尿酸水平均高于健康对照组,而TT_(3)、FT_(4)、HDL水平则低于健康对照组(P均<0.05)。血清尿酸水平升高的NAFLD组和健康对照组患者一般资料和实验室检查结果差异均无统计学意义(P均>0.05)。γ-GT、HDL、TT_(3)、FT_(4)水平是血清尿酸水平正常的NAFLD患者发病的独立影响因素。结论NAFLD发病与甲状腺激素水平的相关性受外周血尿酸水平影响。外周血尿酸水平在正常范围内时,TT_(3)和FT_(4)是NAFLD发病的独立影响因素。

Objective To investigate the relationships between peripheral blood uric acid,thyroid hormone levels and the risk of non-alcoholic fatty liver disease(NAFLD).Methods Totally 139 NAFLD patients(NAFLD group)and 54 healthy adults who underwent physical examinations(healthy control group)were selected.General information and lab‑oratory test results were collected and compared between patients of the two groups,including gender,age,fasting blood glucose(FBS),alanine aminotransferase(ALT),aspartate aminotransferase(AST),γ-glutamyltransferase(γ-GT),tri‑glycerides(TC),total cholesterol(TG),high-density lipoprotein cholesterol(HDL),low-density lipoprotein cholesterol(LDL),serum uric acid,creatinine(Cr),thyroid stimulating hormone(TSH),and total T_(3)(TT_(3)),total thyroxine(TT_(4)),free T_(3)(FT_(3)),and free thyroxine(FT_(4)).Logistic regression method was used to analyze the influencing factors of NAFLD.Logistic regression method was used to analyze the influencing factors of NAFLD with normal and elevated serum uric acid levels by using serum uric acid level of 416μmol/L as the judgment standard.Results The NAFLD group had higher levels of age,ALT,AST,γ-GT,TG,HDL,and uric acid in comparison with those of the healthy control group,while the FT_(4) level was lower(all P<0.05).ALT and HDL levels were independent influencing factors for NAFLD.The age,FBS,ALT,AST,γ-GT,TG,and uric acid levels were higher in the NAFLD group with normal serum uric acid level than in the healthy control group,while TT_(3),FT_(4),and HDL levels were lower(all P<0.05).There were no statistically significant dif‑ferences in general data or laboratory test results between the NAFLD group with elevated serum uric acid levels and thehealthy control group(all P>0.05).Theγ-GT,HDL,TT_(3),and FT_(4) levels were independent risk factors for NAFLD in pa‑tients with normal serum uric acid levels.Conclusions The correlation between the incidence of NAFLD and thyroid hormone level is influenced by the peripheral blood uric acid level.When the peripheral blood uric acid level is within the normal range,TT_(3) and FT_(4) are independent risk factors for the onset of NAFLD.