2021 年第 8 期 第 16 卷

甲状腺激素与非酒精性脂肪性肝病的相关性分析

Correlation between thyroid hormone and non-alcoholic fatty liver disease

作者：邵翠萍徐有青

英文作者：Shao Cuiping Xu Youqing

单位：首都医科大学附属北京天坛医院消化内科100070

英文单位：Department of Gastroenterology Beijing Tiantan Hospital Capital Medical University Beijing 100070 China

关键词：非酒精性脂肪性肝病；脂代谢；甲状腺激素

英文关键词：Non-alcoholicfattyliverdisease;Lipidmetabolism;Thyroidhormone

• 摘要：

• 目的 探讨甲状腺激素与非酒精性脂肪性肝病（NAFLD）的相关性。方法 随机抽取2019年1月1日至2021年1月1日就诊于首都医科大学附属北京天坛医院的轻、中、重度NAFLD患者各30例，归入NAFLD组；另随机抽取同时期于本院完善健康体检者中的30例为健康对照组。采用回顾性分析方法，收集研究对象的一般资料、肝功能及甲状腺激素水平等指标。统计分析组间各临床资料的差异，并通过Spearman秩相关方法分析NAFLD严重程度与甲状腺激素的相关性，Logistic回归方法分析NAFLD相关的危险因素。结果 NAFLD组血清丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）、三酰甘油、γ-谷氨酰转肽酶（γ-GT）水平显著高于健康对照组，而高密度脂蛋白胆固醇、游离甲状腺素（FT4）水平则显著低于健康对照组［（1.19±0.29）mmol/L比（1.58±0.34）mmol/L、（11.3±2.2）pmol/L比（12.8±1.8）pmol/L］，差异均有统计学意义（均P<0.01）。随着NAFLD严重程度的加重，血清ALT、AST、三酰甘油、总胆固醇、低密度脂蛋白胆固醇、γ-GT水平升高，而游离三碘甲状腺原氨酸（FT3）水平降低（均P<0.05）。Spearman秩相关分析结果显示，NAFLD严重程度与血清FT3水平具有显著相关性（r=0.284，P=0.007）。Logistic回归分析结果显示，甲状腺激素中FT4是发生NAFLD的独立危险因素（比值比=0.714，95%置信区间：0.575～0.887，P<0.001）。结论 血清FT4水平与NAFLD的发生密切相关，血清FT3水平随着NAFLD的程度加重显著降低。

• Objective To investigate the correlation between thyroid hormone and non-alcoholic fatty liver disease(NAFLD). Methods From January 1, 2019 to January 1, 2021, 30 patients with each of mild, moderate and severe NAFLD in Beijing Tiantan Hospital, Capital Medical University were randomly selected and constituted the NAFLD group. Other 30 healthy persons who underwent physical examination during the same period in the hospital were randomly selected and constituted the healthy control group. The general data, liver function and thyroid hormone levels of them were collected and retrospectively analyzed. The differences of clinical data between the different groups were statistically analyzed. Spearman rank correlation method was used to analyze the correlation between the severity of NAFLD and thyroid hormone, and Logistic regression method was used to analyze the related risk factors of NAFLD. Results The serum levels of alanine aminotransferase(ALT), aspartate aminotransferase(AST), triacylglycerol and γ-glutamyl transpeptidase(γ-GT) in NAFLD group were significantly higher than those in healthy control group, while the levels of high-density lipoprotein cholesterol and free thyroxine(FT4) in NAFLD group were significantly lower than those in healthy control group［（1.19±0.29）mmol/L vs （1.58±0.34）mmol/L, （11.3±2.2）pmol/L vs （12.8±1.8）pmol/L］(all P<0.01). With the aggravation of NAFLD, serum levels of ALT, AST, triacylglycerol, total cholesterol, low-density lipoprotein cholesterol and γ-GT increased, while the level of free triiodothyronine(FT3) decreased (all P<0.05). Spearman rank correlation analysis showed that there was a significant correlation between NAFLD severity and serum FT3 level(r=0.284, P=0.007). Logistic regression analysis showed that FT4 in thyroid hormone was an independent risk factor for NAFLD(odds ratio=0.714, 95% confidence interval: 0.575-0.887, P<0.001). Conclusion  The serum FT4 level is closely related to the occurrence of NAFLD. With the aggravation of NAFLD, the serum FT3 level decreases significantly.