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. 2024 Jan;44(1):27-38.
doi: 10.1111/liv.15723. Epub 2023 Sep 12.

Association of thyroid function with non-alcoholic fatty liver disease in recent-onset diabetes

Nina Saatmann  1   2 , Martin Schön  1   2 , Oana-Patricia Zaharia  1   2   3 , Maximilian Huttasch  1   2 , Klaus Strassburger  2   4 , Sandra Trenkamp  1   2 , Yuliya Kupriyanova  1   2 , Vera Schrauwen-Hinderling  1   2   5 , Sabine Kahl  1   2   3 , Volker Burkart  1   2 , Robert Wagner  1   2   3 , Michael Roden  1   2   3 ; GDS Group
Collaborators, Affiliations

Association of thyroid function with non-alcoholic fatty liver disease in recent-onset diabetes

Nina Saatmann et al. Liver Int. 2024 Jan.

Abstract

Background and aims: Non-alcoholic fatty liver disease (NAFLD) has been linked to type 2 diabetes (T2D), but also to hypothyroidism. Nevertheless, the relationship between thyroid function and NAFLD in diabetes is less clear. This study investigated associations between free thyroxine (fT4) or thyroid-stimulating hormone (TSH) and NAFLD in recent-onset diabetes.

Methods: Participants with recent-onset type 1 diabetes (T1D, n = 358), T2D (n = 596) or without diabetes (CON, n = 175) of the German Diabetes Study (GDS), a prospective longitudinal cohort study, underwent Botnia clamp tests and assessment of fT4, TSH, fatty liver index (FLI) and in a representative subcohort 1 H-magnetic resonance spectroscopy.

Results: First, fT4 levels were similar between T1D and T2D (p = .55), but higher than in CON (T1D: p < .01; T2D: p < .001), while TSH concentrations were not different between all groups. Next, fT4 correlated negatively with FLI and positively with insulin sensitivity only in T2D (ß = -.110, p < .01; ß = .126, p < .05), specifically in males (ß = -.117, p < .05; ß = .162; p < .01) upon adjustments for age, sex and BMI. However, correlations between fT4 and FLI lost statistical significance after adjustment for insulin sensitivity (T2D: ß = -.021, p = 0.67; males with T2D: ß = -.033; p = .56). TSH was associated positively with FLI only in male T2D before (ß = .116, p < .05), but not after adjustments for age and BMI (ß = .052; p = .30).

Conclusions: Steatosis risk correlates with lower thyroid function in T2D, which is mediated by insulin resistance and body mass, specifically in men, whereas no such relationship is present in T1D.

Keywords: diabetes mellitus type 2; humans; non-alcoholic fatty liver; thyroid diseases; thyroxine.

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References

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