Xiaowen Zhang
*
Jie Liu
*
Wenhuan Feng
*The final, formatted version of the article will be published soon.
ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Thyroid Endocrinology
Volume 15 - 2024 |
doi: 10.3389/fendo.2024.1450049
Impaired Sensitivity to Thyroid Hormone Is Associated with Developing non-alcoholic fatty liver disease in Euthyroid Diabetic Subjects
Provisionally accepted- Nanjing Drum Tower Hospital, Nanjing, Jiangsu Province, China
Background and Aims: Acquired resistance to thyroid hormone mightappears to exist in the general population. We aimed to evaluate the association between indices of thyroid hormone sensitivity and non-alcoholic fatty liver disease (NAFLD), and made stratified analyses by diabetic status.We included 26,413 participants from a health screening program and 8,246 hospitalized patients with type 2 diabetes. Thyroid Feedback Quantile-based Index (TFQI), thyroid stimulating hormone index (TSHI) and thyrotroph thyroxine resistance index (TT4RI) were calculated. Advanced fibrosis risk was determined using the FIB-4 score. Multivariate logistic regression analysis was performed.Results: TFQI was associated with an increased risk of NAFLD in patients with diabetes (fourth quartile vs. first quartile: odds ratio [OR]=1.39 and 1.82 in hospitalized and non-hospitalized patients, respectively, both P<0.001) but not non-diabetic participants (OR=0.94, P=0.40). Further adjustment for the homeostasis model assessment of insulin resistance generated similar findings in diabetes (OR=1.27, P=0.025). The TFQI-associated NAFLD risk increase in diabetic patients was confined to NAFLD with low probability of advanced fibrosis (OR 1.42, P=0.001), but not those with intermediate-to-high probability (OR=0.86, P=0.23). Also, TFQI was associated with a significantly lower risk for advanced fibrosis in the diabetic at-risk patients (OR=0.62, P=0.005) but not those nondiabetic at-risk participants, independent of the presence of NAFLD. The association was less remarkablesignificant for TT4RI and TSHI.Conclusions: Impaired sensitivity to thyroid hormone was associated with an increased risk of developing NAFLD but a reduced risk of advanced fibrosis limited to diabetic individuals. Our findings suggest stratified studiesy of NAFLD based on diabetic status are needed in the future.
Keywords: ALT, alanine aminotransferase, AST, aspartate aminotransferase, BMI: Body Mass Index, CIs, Confidence intervals, CKD, chronic kidney disease, eGFR, estimated glomerular filtration rate, FPG: Fasting plasma glucose, fT3, free triiodothyronine
Received: 16 Jun 2024; Accepted: 29 Nov 2024.
Copyright: © 2024 Zhang, Liu, Wang, Han, Yan, Shen and Feng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Xiaowen Zhang, Nanjing Drum Tower Hospital, Nanjing, 210008, Jiangsu Province, China
Jie Liu, Nanjing Drum Tower Hospital, Nanjing, 210008, Jiangsu Province, China
Qian Wang, Nanjing Drum Tower Hospital, Nanjing, 210008, Jiangsu Province, China
Chen Han, Nanjing Drum Tower Hospital, Nanjing, 210008, Jiangsu Province, China
Yu Yan, Nanjing Drum Tower Hospital, Nanjing, 210008, Jiangsu Province, China
Shan-Mei Shen, Nanjing Drum Tower Hospital, Nanjing, 210008, Jiangsu Province, China
Wenhuan Feng, Nanjing Drum Tower Hospital, Nanjing, 210008, Jiangsu Province, China
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