中西医结合肝病杂志2025，Vol.35Issue(9)：1078-1082,5.DOI:10.3969/j.issn.1005-0264.2025.009.005
甲状腺功能相关指标对甲状腺功能减退症合并非酒精性脂肪性肝病患者肝纤维化的预测价值
The predictive value of thyroid function related indicators for liver fibrosis in hypothyroidism patients with non-alcoholic fatty liver disease
摘要
Abstract
Objective:To investigate the predictive value of thyroid function related indicators for liver fibrosis in hypothyroidism patients with non-alcoholic fatty liver disease(NAFLD).Methods:A total of 98 hypothyroidism patients with NAFLD who were hospitalized in our hospital from March 2021 to March 2024 were selected as the study subjects.They were divided into the liver fibrosis group of 41 cases(41.8%)and non liver fibrosis group of 57 cases(58.2%)according to whether to merge liver fibrosis.The general clinical data and thyroid gland function related indicators of patients between the two groups were compared,and the independent risk factors of liver fibrosis in hypothyroidism patients with NAFLD were obtained through multifactor logistic regression analysis.The analysis was focused on the correlation between thyroid function related indicators and liver fibrosis in hypothyroidism patients with NAFLD.ROC curve and decision curve were drawn to verify the value of thyroid function in predicting liver fibrosis in hypothyroidism patients with NAFLD.Results:The levels of serum triglyceride(TG),cholesterol(TC),low-density lipoprotein(LDL),insulin resistance index(HOMA-IR),C-reactive,thyrotropin(TSH),free triiodothyronine(FT3)and free thyroxine(FT4)protein of patients in liver fibrosis group were significantly higher than those in non liver fibrosis group(P<0.05).Multivariate logistic regression analysis showed that TSH,FT3,and FT4 were independent risk factors of liver fibrosis in hypothyroidism patients with NAFLD(P<0.05).ROC analysis showed that when TSH≥6.2 mU/L,FT3≤4.0 pmol/L and FT4≤9.6 pmol/L,the area under the curve(AUC)of TSH,FT3 and FT4 predicting liver fibrosis in hypothyroidism patients with NAFLD were 0.745(0.703-0.793),0.765(0.724-0.811)and 0.853(0.804-0.898),respectively,the combination prediction of the three indicators had the highest value with AUC of 0.931(0.894-0.974).The analysis results of the decision curve showed that TSH,FT3,and FT4 had good net returns on predicting liver fibrosis in hypothyroidism patients with NAFLD within most reasonable threshold probabilities.Conclusion:The TSH,FT3,and FT4 have good value in predicting liver fibrosis in hypothyroidism patients with NAFLD.关键词
甲状腺功能/甲状腺功能减退症/非酒精性脂肪性肝病/肝纤维化Key words
thyroid function/hypothyroidism/nonalcoholic fatty liver disease/liver fibrosis分类
医药卫生引用本文复制引用
王怡然,丁兴龙,郭继强..甲状腺功能相关指标对甲状腺功能减退症合并非酒精性脂肪性肝病患者肝纤维化的预测价值[J].中西医结合肝病杂志,2025,35(9):1078-1082,5.基金项目
国家重点研发计划(No.2019YFF0216501-L33) （No.2019YFF0216501-L33）
