男女2型糖尿病合并非酒精性脂肪性肝病患者血清性激素和甲状腺激素水平变化分析*

doi:10.3969/j.issn.1672-5069.2025.05.013

摘要/Abstract

摘要： 目的探讨不同性别2型糖尿病(T2DM)合并非酒精性脂肪性肝病(NAFLD)患者血清性激素和甲状腺激素水平变化。方法 2021年1月～2023年12月我院诊治的T2DM合并NAFLD患者100例(男62例,女38例)和T2DM患者100例(男57例,女43例)。采用化学发光免疫分析法检测血清睾酮(T)、雌二醇(E2)、卵泡刺激素(FSH)、黄体生成素(LH)及游离三碘甲状腺原氨酸(FT3)、游离四碘甲状腺原氨酸(FT4)和促甲状腺激素(TSH)水平。采用多因素Logistic回归分析T2DM患者合并NAFLD的危险因素。结果男性T2DM合并NAFLD患者腰围、体质指数、血清E2和TSH水平分别为(92.4±11.2)cm、(26.5±2.5)kg/m²、(23.5±7.8)pg/mL和(3.1±0.5)mU/L,均显著大于或高于T2DM患者【分别为(87.7±9.4)cm、(24.6±2.2)kg/m²、(17.2±5.6)pg/mL和(2.1±0.4)mU/L,P＜0.05】,而血清T水平为(3.5±1.1)ng/mL,显著低于T2DM患者【(4.6±1.5)ng/mL,P＜0.05】;多因素Logistic回归分析显示,血清T、E2和TSH水平是影响男性T2DM患者合并NAFLD的危险因素(P＜0.05);女性T2DM合并NAFLD患者腰围、体质指数和血清TSH水平分别为(81.6±8.0)cm、(26.7±2.3)kg/m²和(3.3±0.6)mU/L,均显著大于或高于T2DM患者【分别为(77.3±7.1)cm、(24.4±2.1)kg/m²和(2.5±0.5)mU/L,P＜0.05】,而血清E2和FSH水平分别为(20.4±6.5)pg/mL和(59.8±11.5)mIU/mL,均显著低于T2DM患者【分别为(26.3±7.9)pg/mL和(71.7±13.8)mIU/mL,P＜0.05】;多因素Logistic回归分析显示,血清E2、FSH和TSH水平是影响女性T2DM患者合并NAFLD的危险因素(P＜0.05)。结论 T2DM合并NAFLD患者存在明显的性激素和甲状腺激素水平异常,深入研究它们的作用,对于防治疾病具有重要的临床意义。

关键词: 非酒精性脂肪性肝病, 2型糖尿病, 性激素, 甲状腺激素

Abstract: Objective The aim of this study was to investigate changes of serum sex hormones and thyroid hormones in patients with type 2 diabetes mellitus (T2DM) and non-alcoholic fatty liver disease (NAFLD). Methods The general clinical materials were collected from 100 patients with T2DM and NAFLD, and 100 patients with T2DM in our hospital between January 2021 and December 2023. Serum testosterone (T), estradiol (E2), follicle stimulating hormone (FSH) and luteinizing hormone (LH), as well as serum free triiodothyronine (FT3), free tetraiodothyronine (FT4) and thyroid stimulating hormone (TSH) were detected by chemiluminescence immunoassay. The risk factors of NAFLD in patients with T2DM were analyzed by multivariate Logistic regression analysis. Results Waist circumference (WC), body mass index (BMI), serum E2 and TSH levels in male patients with T2DM and concomitant NAFLD were (92.4±11.2)cm, (26.5±2.5)kg/m², (23.5±7.8)pg/mL and (3.1±0.5)mU/L, all significantly higher or greater than [(87.7±9.4)cm, (24.6±2.2)kg/m², (17.2±5.6)pg/mL and (2.1±0.4)mU/L, respectively, P＜0.05], while serum T level was (3.5±1.1)ng/mL, significantly lower than [(4.6±1.5)ng/mL, P＜0.05] in patients with T2DM; multivariate Logistic regression analysis showed that serum T, E2 and TSH levels were all the independent risk factors for NAFLD existence in patients with T2DM(P＜0.05); WC, BMI and serum TSH level in female patients with T2DM and NAFLD were(81.6±8.0)cm, (26.7±2.3)kg/m² and (3.3±0.6)mU/L, all significantly greater or higher than [(77.3±7.1)cm, (24.4±2.1)kg/m² and (2.5±0.5)mU/L, respectively, P＜0.05], while serum E2 and FSH levels were (20.4±6.5)pg/mL and (59.8±11.5)mIU/mL, both significantly lower than [(26.3±7.9)pg/mL and (71.7±13.8)mIU/mL, respectively, P＜0.05] in patients with T2DM; multivariate Logistic regression analysis demonstrated that serum E2, FSH and TSH levels were all the independent risk factors for NAFLD existence in patients with T2DM(P＜0.05). Conclusion Sex hormones and thyroid hormones are obviously abnormal in both male and female patients with T2DM and NAFLD, and the in-depth study might clarify the mechanism of the entity.

Key words: Non-alcoholic fatty liver disease, Type 2 diabetes mellitus, Sex hormone, Thyroid hormone

陈瑞婷, 袁克敏, 彭小龙. 男女2型糖尿病合并非酒精性脂肪性肝病患者血清性激素和甲状腺激素水平变化分析^*[J]. 实用肝脏病杂志, 2025, 28(5): 691-694.

Chen Ruiting, Yuan Kemin, Peng Xiaolong. Changes of serum sex hormones and thyroid hormones in patients with type 2 diabetes mellitus and non-alcoholic fatty liver disease[J]. Journal of Practical Hepatology, 2025, 28(5): 691-694.

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男女2型糖尿病合并非酒精性脂肪性肝病患者血清性激素和甲状腺激素水平变化分析^*

Changes of serum sex hormones and thyroid hormones in patients with type 2 diabetes mellitus and non-alcoholic fatty liver disease

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