背景:我们旨在研究2型糖尿病(T2DM)患者中性别和甲状腺相关激素与代谢功能障碍相关性脂肪肝(MAFLD)风险之间的性别特异性关联。
方法:对厦门432名T2DM患者(185名女性和247名男性)的基线信息进行横断面分析,中国进行。血浆性激素,包括雌二醇(E2),卵泡刺激素(FSH),黄体生成素(LH),催乳素(PRL),黄体酮,和总睾酮(TT),和甲状腺相关的激素,包括游离三碘甲状腺原氨酸(FT3),游离甲状腺素(FT4),促甲状腺激素(TSH),和甲状旁腺激素(PTH),使用化学发光免疫测定法进行测量。MAFLD被定义为存在肝脂肪变性(通过肝超声扫描或脂肪肝指数(FLI)评分>60诊断),因为在本研究中所有受试者均患有T2DM。
结果:男性和女性T2DM患者MAFLD的患病率分别为65.6%和61.1%(P=0.335)。对于男人来说,MAFLD患者的FSH水平显着降低(中位数(四分位数间距(IQR)):7.2(4.9-11.1)vs.9.8(7.1-12.4)mIU/ml)和TT(13.2(10.4-16.5)vs.16.7(12.8-21.6)nmol/L)以及FT3水平的增加(平均值±标准偏差(SD):4.63±0.68vs.4.39±0.85pmol/L)比没有MAFLD的那些(所有p值<0.05)。在调整了潜在的混杂因素后,FSH和LH均为阴性,虽然孕酮与男性MAFLD的风险呈正相关,调整后的比值比(ORs)(95%置信区间(CIs))为0.919(0.856-0.986),0.888(0.802-0.983),和8.069(2.019-32.258)(所有p值<0.05),分别。在女性中,性别相关激素或甲状腺相关激素与MAFLD风险之间无统计学显著关联.
结论:FSH和LH水平为阴性,而在T2DM男性患者中,孕酮与MAFLD风险呈正相关.筛查MAFLD和监测性激素对T2DM患者很重要,尤其是男人。
BACKGROUND: We aimed to examine sex-specific associations between sex- and thyroid-related hormones and the risk of metabolic dysfunction-associated fatty liver disease (MAFLD) in patients with type 2 diabetes mellitus (T2DM).
METHODS: Cross-sectional analyses of baseline information from an ongoing cohort of 432 T2DM patients (185 women and 247 men) in Xiamen, China were conducted. Plasma sex-related hormones, including estradiol (E2), follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), progesterone, and total testosterone (TT), and thyroid-related hormones, including free triiodothyronine (FT3), free thyroxine (FT4), thyroid-stimulating hormone (TSH), and parathyroid hormone (PTH), were measured using chemiluminescent immunoassays. MAFLD was defined as the presence of hepatic steatosis (diagnosed by either hepatic ultrasonography scanning or fatty liver index (FLI) score > 60) since all subjects had T2DM in the present study.
RESULTS: Prevalence of MAFLD was 65.6% in men and 61.1% in women with T2DM (P = 0.335). For men, those with MAFLD showed significantly decreased levels of FSH (median (interquartile range (IQR)):7.2 (4.9-11.1) vs. 9.8 (7.1-12.4) mIU/ml) and TT (13.2 (10.4-16.5) vs. 16.7 (12.8-21.6) nmol/L) as well as increased level of FT3 (mean ± standard deviation (SD):4.63 ± 0.68 vs. 4.39 ± 0.85 pmol/L) than those without MAFLD (all p-values < 0.05). After adjusting for potential confounding factors, FSH and LH were negative, while progesterone was positively associated with the risk of MAFLD in men, and the adjusted odds ratios (ORs) (95% confidence intervals (CIs)) were 0.919 (0.856-0.986), 0.888 (0.802-0.983), and 8.069 (2.019-32.258) (all p-values < 0.05), respectively. In women, there was no statistically significant association between sex- or thyroid-related hormones and the risk of MAFLD.
CONCLUSIONS: FSH and LH levels were negative, whereas progesterone was positively associated with the risk of MAFLD in men with T2DM. Screening for MAFLD and monitoring sex-related hormones are important for T2DM patients, especially in men.