文章摘要
刘丽娟,甄东户,汤旭磊,傅松波,杨晓梅,马小妮.中老年人促甲状腺素水平与新发非酒精性脂肪性肝病的相关性研究[J].南京医科大学学报,2021,(3):369~375
中老年人促甲状腺素水平与新发非酒精性脂肪性肝病的相关性研究
Association between thyroid stimulating hormone and incident non⁃alcoholic fatty liver disease in middle⁃aged and elderly population
投稿时间:2020-05-08  
DOI:10.7655/NYDXBNS20210310
中文关键词: 促甲状腺素  非酒精性脂肪性肝病  发病率
英文关键词: thyroid stimulating hormone  non⁃alcoholic fatty liver disease  incidence
基金项目:甘肃省卫生行业科研计划(GSWSKY?2014?27,GSWST2010?03);甘肃省自然科学基金计划项目(1606RJZA347);标准化代谢性疾病管理中心(MMC)专项研究基金(2018?mmczxjj?3)
作者单位
刘丽娟 兰州大学第一医院内分泌科甘肃 兰州 730000 
甄东户 兰州大学第一医院内分泌科甘肃 兰州 730000 
汤旭磊 兰州大学第一医院内分泌科甘肃 兰州 730000 
傅松波 兰州大学第一医院内分泌科甘肃 兰州 730000 
杨晓梅 兰州大学第一医院内分泌科甘肃 兰州 730000 
马小妮 兰州大学第一医院内分泌科甘肃 兰州 730000 
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中文摘要:
      目的:分析兰州市社区中老年人群促甲状腺素(thyroid stimulating hormone,TSH)水平与3年随访时新发非酒精性脂肪性肝病(non?alcoholic fatty liver disease,NAFLD)的相关性。方法:选取兰州市社区2011年基线调研时40~75岁甲状腺功能(甲功)正常(727例)及亚临床甲状腺功能减退症(亚临床甲减,222例)的无脂肪肝人群,于2014年进行随访,采集人体学指标,检测甲状腺激素水平、血糖、血脂、肝酶等,并检查上腹部超声。结果:亚临床甲减3年缓解率为27.93%(62/222);基线甲功正常人群中亚临床甲减3年新发率为16.64%(121/727)。随着基线TSH水平的升高,总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL?C)、天门冬氨酸氨基转移酶(aspartate aminotransferase,AST)水平逐渐升高(P均<0.05)。仅在女性中,不同基线TSH水平人群NAFLD 3年发病率差异有统计学意义(P < 0.05)。Logistic回归分析显示,女性中,在模型1未校正及模型2校正年龄、基线体重指数(body mass index,BMI)、基线TG、基线糖化血红蛋白(HbA1c)后,基线TSH与NAFLD 3年发病风险呈正相关(P均<0.05);在模型3进一步校正BMI差值、HbA1c差值后,二者的相关性无统计学意义。结论:中老年女性中,基线TSH水平是NAFLD 3年发病的影响因素,但二者无独立相关性。
英文摘要:
      Objective:The objective of the study was to investigate the association between thyroid stimulating hormone(TSH) and incident non?alcoholic fatty liver disease(NAFLD) in middle?aged and elderly population in a 3?year follow?up study. Methods:Total 222 subclinically hypothyroid(TSH>4.50 mU/L)and 727 euthyroid people aged 40~75 years who were free of fatty liver disease at baseline in a community were included in the current study. The study population was screened initially in 2011 and re?evaluated in 2014. On both occasions they were assessed by structured interview via a questionnaire on general information,anthropometric measurements,thyroid hormones,biochemical and serological tests,liver ultrasound. Results:Among 222 baseline subclinical hypothyroidism patients,62(27.93%) reverted to euthyroidism at a 3?year follow?up. The 3?year incidence of subclinical hypothyroidism was 16.64%(121/727). Higher TSH levels at baseline were associated with higher total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL?C) and aspartate aminotransferase(AST) levels(P < 0.05). The incidence rate of NAFLD increased with increasing baseline TSH levels in female(P < 0.05). Logistic regression analyses showed,higher baseline TSH levels were associated with the diagnosis of NAFLD by unadjusted in model 1 in female. After adjustment for age,baseline BMI,baseline TG,baseline HbA1c in model 2,this association remained significant. When data were adjusted for the changes in BMI and changes in HbA1c in model 3,the association was no longer significant. Conclusion:Among middle?aged and elderly population,baseline TSH was an influencing factor,but not an independent risk factors,for 3?year incidence of NAFLD in female.
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