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Correlation between thyroid function, sensitivity to thyroid hormones and metabolic dysfunction-associated fatty liver disease in euthyroid subjects with newly diagnosed type 2 diabetes

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Abstract

Purpose

To estimate the prevalence of metabolic dysfunction-associated fatty liver disease (MAFLD) and to evaluate the associations between thyroid parameters, MAFLD and liver fibrosis in euthyroid patients with newly diagnosed type 2 diabetes mellitus (T2DM).

Methods

Overall, 776 patients with newly diagnosed T2DM and 120 subjects without diabetes were included. All the participants were euthyroid, and were categorized as non-MAFLD and MAFLD. Demographic information, biochemical parameters, and serum thyroid hormones were collected. The thyroid hormone sensitivity indices were calculated. MAFLD was defined according to abdominal ultrasound and clinical manifestations. Noninvasive fibrosis indices were calculated to identify advanced liver fibrosis.

Results

The prevalence of MAFLD was significantly higher in patients with T2DM than in subjects without diabetes. Levels of free triiodothyronine (FT3) and FT3 to free thyroxine (FT4) ratio were significantly higher in subjects with MAFLD. In patients with T2DM, levels of thyroid stimulating hormone (TSH), Thyroid feedback quantile-based index (TFQIFT3) calculated using FT3 and TSH, thyrotroph T3 resistance index (TT3RI) and thyrotroph T4 resistance index (TT4RI) were significantly higher in subjects with MAFLD. The prevalence of MAFLD increased with the rise of FT3, FT3/FT4, TSH, and sensitivity to thyroid hormone indices (TFQIFT3, TT3RI, and TT4RI). But significant correlations were not found between thyroid hormones, sensitivity to thyroid hormones and MAFLD, after adjustment for BMI and HOMA-IR. The incidence of advanced fibrosis tended to increase as the rise of TSH and sensitivity to thyroid hormone indices (TFQIFT3, TT3RI, TT4RI, and TSHI).

Conclusion

MAFLD was prevalent in euthyroid patients with newly diagnosed T2DM. Higher normal FT3, TSH and impaired sensitivity to thyroid hormones are associated with increased incidence of MAFLD, being dependent on other metabolic factors.

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Funding

The present study was supported by grant from National Natural Science Foundation of China (grant number 81800726).

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Authors and Affiliations

  1. Department of Endocrinology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China

    Xiaodan Zhang, Huiyu Ye, Zhishan Chen, Enting Zhang & Wangen Li

  2. Health Examination Department, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China

    Yimei Chen

  3. The Second Clinical Medicine School, Guangzhou Medical University, Guangzhou, China

    Zirui Luo & Jiahong Li

Authors
  1. Xiaodan Zhang
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  2. Yimei Chen
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  3. Huiyu Ye
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  4. Zirui Luo
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  5. Jiahong Li
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  6. Zhishan Chen
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  7. Enting Zhang
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  8. Wangen Li
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Contributions

XZ and WL contributed to the study conception and design. Data collection and analysis were performed by XZ, YC, HY, ZL, JL, ZC, and EZ. The first draft of the manuscript was written by XZ and all authors commented on previous versions of the manuscript. The manuscript was reviewed and revised by WL. All authors read and approved the final manuscript.

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Correspondence to Wangen Li.

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The authors declare no competing interests.

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Since the present study is retrospective and the data are anonymous, individual consent from participant was waived.

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The study was conducted in accordance with the principles of the Declaration of Helsinki and was approved by the Ethics Committee of The Second Affiliated Hospital of Guangzhou Medical University (Approval number 2022-hg-ks-16).

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Zhang, X., Chen, Y., Ye, H. et al. Correlation between thyroid function, sensitivity to thyroid hormones and metabolic dysfunction-associated fatty liver disease in euthyroid subjects with newly diagnosed type 2 diabetes. Endocrine 80, 366–379 (2023). https://doi.org/10.1007/s12020-022-03279-2

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  • DOI: https://doi.org/10.1007/s12020-022-03279-2

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