Free T4 is Negatively Correlated with Non-alcoholic Fatty Liver Disease in Euthyroid Women

E. Jun, Hyun Sook Kim, H. Chung, J. Lee, S. Kim, E. Jung
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Abstract

Background: Thyroid hormones play an important role in the regulation of lipid and carbohydrate metabolism and the body mass index (BMI), which all affect non-alcoholic fatty liver disease (NAFLD). In a previous study, we demonstrated that free T4 was negatively associated with the BMI in euthyroid women. However, there is still uncertain as to whether the thyroid function within the normal range is associated with NAFLD and liver function abnormalities. We sought to evaluate the thyroid function (free T4, TSH) and its possible relationship with NAFLD in euthyroid women. Methods: A total of 835 euthyroid, non heavy alcoholics women who visit ed the Daegu Catholic University University Medical Centre for primary health screening from January 1, 2006 to December 31, 2006 participated in this cross-sectional study. The women who were not euthyroid or heavy alcoholics (> 70 g/week in women according to the DSM-IV), there was no known history of diabetes mellitus, the fasting blood glucose was more than 5.55 mmol/L and those who had viral hepatitis were excluded. Hepatic ultrasonography scanning was performed in all the participants by a single experienced radiologist. The TSH, free T4, BP, fasting glucose, serum liver enzymes (AST, ALT, GGT, T-bilirubin), lipid profiles [total-cholesterol, triglyceride (TG), HDL-C, LDL-C] and NAFLD were evaluated. Results: Euthyroid women with NAFLD had lower free T4 levels than did the euthyroid women without NAFLD. After adjustment for age and BMI, free T4 was negatively correlated with TG, but free T4 was positively correlated with the total serum bilirubin. Free T4 was not correlated with the serum AST, ALT and GGT. After adjustment for age, the BMI, the fasting glucose, the GGT and free T4, but not TSH, were significantly negatively correlated with NAFLD. Conclusion: We demonstrated a negative correlation between free T4 and NAFLD in euthyroid women. This finding suggests lower levels of free T4 is associated with NAFLD in euthyroid subjects. (J Korean
甲状腺功能正常妇女游离T4与非酒精性脂肪肝呈负相关
背景:甲状腺激素在调节脂质和碳水化合物代谢以及身体质量指数(BMI)中发挥重要作用,这些都与非酒精性脂肪性肝病(NAFLD)有关。在之前的一项研究中,我们证明了在甲状腺功能正常的女性中,游离T4与BMI呈负相关。然而,正常范围内的甲状腺功能是否与NAFLD和肝功能异常相关仍不确定。我们试图评估甲状腺功能(游离T4, TSH)及其与NAFLD的可能关系。方法:对2006年1月1日至2006年12月31日在大邱天主教大学医学中心接受初级健康检查的835名甲状腺功能正常、非重度酗酒妇女进行横断面研究。排除甲状腺功能不正常或重度酗酒者(根据DSM-IV > 70 g/周)、无糖尿病史、空腹血糖大于5.55 mmol/L、有病毒性肝炎者。所有参与者的肝脏超声扫描均由一位经验丰富的放射科医生进行。评估TSH、游离T4、BP、空腹血糖、血清肝酶(AST、ALT、GGT、t -胆红素)、血脂[总胆固醇、甘油三酯(TG)、HDL-C、LDL-C]和NAFLD。结果:甲状腺功能正常的NAFLD患者游离T4水平低于非NAFLD患者。调整年龄和BMI后,游离T4与TG呈负相关,而游离T4与血清总胆红素呈正相关。游离T4与血清AST、ALT、GGT无相关性。调整年龄后,BMI、空腹血糖、GGT和游离T4与NAFLD呈显著负相关,TSH无显著负相关。结论:甲状腺功能正常的妇女游离T4与NAFLD呈负相关。这一发现表明,在甲状腺功能正常的受试者中,游离T4水平较低与NAFLD有关。(J韩国
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