Free Triiodothyronine Is Independently Associated with Nonalcoholic Fatty Liver Disease in Hospitalized Type 2 Diabetes Mellitus Patients

Abstract

Objective. Free triiodothyronine (FT3) is an independent risk factor for nonalcoholic fatty liver disease (NAFLD) in patients with euthyroid. However, whether FT3 has an independent effect on NAFLD in a population of type 2 diabetes remains unknown. The purpose of this study was to identify the potential role of FT3 in NAFLD with T2DM. Design. A cross-sectional study. Patient. A total of 859 T2DM patients who met the inclusion criteria were included. There were 506 T2DM patients without NAFLD and 353 T2DM patients with NAFLD. Methods. The independent samples t -test or Wilcoxon rank sum test were used for continuous variables of different distribution types, while the chi-square test was used for categorical variables. Pearson correlation analysis and linear regression were used to analyze the correlation between FT3 and clinical measurements and biochemical indicators. Multivariate logistic regression analysis was used to determine independent predictors. Results. Patients with NAFLD had higher BMI, SBP, and DBP, longer duration of T2DM, and higher islet function index, blood glucose index, liver function index, renal function index, blood lipid index, and FT3. We also found that FT3 was affected by other five indicators, including ALT, CR, GGT, TC, and LDL-C only in the NAFLD group but not in the non-NAFLD group. FT3 was significantly associated with NAFLD in T2DM patients, and the prevalence of NAFLD increased gradually from the lowest FT3 tertile to the highest FT3 tertile ( P for trend < 0.001 ). Conclusion. FT3 is independently associated with NAFLD in hospitalized T2DM patients after rigorous adjustment for various metabolic parameters.

Unraveling the Role of Hypothyroidism in Non-alcoholic Fatty Liver Disease Pathogenesis: Correlations, Conflicts, and the Current Stand

“…After applying inclusion and exclusion criteria, 44 full-text articles were found to be potentially eligible. Of these, 10 articles [ 15 - 24 ] were identified as suitable to the aims of our research question and met the quality specifications necessary for this systematic review.…”

“…All of these studies were published between 2011 and 2021. The following studies were included: Janovsky et al [ 15 ], Tahara et al [ 16 ], Wang et al [ 17 ], Bano et al [ 18 ], Eshraghian et al [ 19 ], Gökmen et al [ 20 ], Lee et al [ 21 ], Ludwig et al [ 22 ], Mazo et al [ 23 ], and Shi et al [ 24 ]. Five of these studies were conducted in Asia, two in South America, two in Europe, and one in the Middle East.…”

“…Out of 10 studies, nine [ 15 - 22 , 24 ] evaluated the association between TSH levels and NAFLD risk. Janovsky et al [ 15 ] detected that among euthyroid individuals, higher TSH values were associated with higher NAFLD prevalence (OR = 1.22; p < 0.01) after adjusting for age and gender.…”

“…Ludwig et al [ 22 ] noted that TSH levels (OR = 0.992; CI: 0.945-1.042; p = 0.7453) were not significantly associated with NAFLD risk. Shi et al [ 24 ] found that there was no significant difference in TSH levels (p > 0.05) between NAFLD and non-NAFLD groups.…”

“…A total of eight studies [ 16 - 22 , 24 ] evaluated the role of T4 levels in NAFLD risk. Tahara et al [ 16 ] observed that FT4 levels were not significantly associated with NAFLD (OR = 0.12; 95% CI: 0.01-1.31; p = 0.083) risk.…”