Prevalence of subclinical hypothyroidism and longitudinal thyroid stimulating hormone changes in youth with metabolic dysfunction-associated steatotic liver disease: an observational study

IF 12.9 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY
Matthew Untalan, Nancy Crimmins, Katherine P. Yates, Ali Mencin, Stavra Xanthakos, Vidhu V. Thaker
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Abstract

Background: Studies on adults have shown an association between overt or subclinical hypothyroidism (SH) and metabolic dysfunction-associated steatotic liver disease (MASLD). The goal of this study was to assess the relationship between thyroid-stimulating hormone (TSH) levels and the histological characteristics of MASLD in youth. Methods: This observational study used prospectively collected liver biopsy and clinical data from youth enrolled in two pediatric clinical trials in the Nonalcoholic Steatohepatitis Clinical Research Network (NASH CRN). Thyroid assays were compared between youth with MASLD and population-based controls aged ≤18 years from the National Health and Nutrition Examination Survey (NHANES). Individuals with overt hypothyroidism, abnormal anti-thyroid antibody, or thyroid-related medications were excluded. SH was defined as TSH between 4.5–10.0 uIU/L. Multinomial logistic regression was used to test the association between TSH and MASLD histological changes at baseline, adjusting for age, sex, race/ethnicity, and body mass index. Mixed-effect models, including treatment and time, were used for the longitudinal analysis. Results: Mean TSH, total thyroxine (T4), total triiodothyronine (T3), and free T4 levels were higher (p<0.001) in the NASH CRN cohort (n=218; 421 observations) than in the NHANES cohort (n=2,198). TSH levels were positively associated with increased steatosis over time (p=0.03). SH was associated with borderline or definite metabolic-associated steatohepatitis on histology at baseline (p=0.03) and with changes in fibrosis over time (p=0.01). Conclusion: The association between TSH and steatosis severity in individuals with normal thyroid hormone concentrations suggests an independent role of TSH in MASLD.
代谢功能障碍相关脂肪性肝病青少年亚临床甲状腺功能减退症的患病率和促甲状腺激素的纵向变化:一项观察性研究
背景:对成年人的研究表明,明显或亚临床甲状腺功能减退症(SH)与代谢功能障碍相关性脂肪性肝病(MASLD)之间存在关联。本研究的目的是评估青少年促甲状腺激素(TSH)水平与 MASLD 组织学特征之间的关系。研究方法这项观察性研究采用了前瞻性收集的肝脏活检和临床数据,这些数据来自参加非酒精性脂肪性肝炎临床研究网络(NASH CRN)两项儿科临床试验的青少年。研究人员比较了MASLD患者与全国健康与营养调查(NHANES)中年龄≤18岁的人群对照组的甲状腺检测结果。排除了患有明显甲状腺功能减退症、抗甲状腺抗体异常或服用甲状腺相关药物的个体。SH定义为TSH在4.5-10.0 uIU/L之间。多项式逻辑回归用于检验 TSH 与基线 MASLD 组织学变化之间的关系,并对年龄、性别、种族/人种和体重指数进行了调整。纵向分析采用了包括治疗和时间在内的混合效应模型。结果显示NASH CRN队列(n=218;421个观测值)中的平均促甲状腺激素、总甲状腺素(T4)、总三碘甲状腺原氨酸(T3)和游离 T4 水平均高于 NHANES 队列(n=2,198)(p<0.001)。随着时间的推移,TSH 水平与脂肪变性的增加呈正相关(p=0.03)。SH 与基线组织学显示的边缘或明确代谢相关性脂肪性肝炎相关(p=0.03),并与纤维化随时间的变化相关(p=0.01)。结论在甲状腺激素浓度正常的个体中,促甲状腺激素与脂肪变性严重程度之间的关联表明,促甲状腺激素在 MASLD 中发挥着独立作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Hepatology
Hepatology 医学-胃肠肝病学
CiteScore
27.50
自引率
3.70%
发文量
609
审稿时长
1 months
期刊介绍: HEPATOLOGY is recognized as the leading publication in the field of liver disease. It features original, peer-reviewed articles covering various aspects of liver structure, function, and disease. The journal's distinguished Editorial Board carefully selects the best articles each month, focusing on topics including immunology, chronic hepatitis, viral hepatitis, cirrhosis, genetic and metabolic liver diseases, liver cancer, and drug metabolism.
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