TY - JOUR
T1 - Association of thyroid function with non-alcoholic fatty liver disease in recent-onset diabetes
AU - Saatmann, Nina
AU - Schön, Martin
AU - Zaharia, Oana Patricia
AU - Huttasch, Maximilian
AU - Strassburger, Klaus
AU - Trenkamp, Sandra
AU - Kupriyanova, Yuliya
AU - Schrauwen-Hinderling, Vera
AU - Kahl, Sabine
AU - Burkart, Volker
AU - Wagner, Robert
AU - Roden, Michael
N1 - Funding Information:
The GDS was initiated and financed by the DDZ, which is funded by the German Federal Ministry of Health (Berlin, Germany) and the Ministry of Culture and Science of the State of Northrhine-Westphalia (Düsseldorf, Germany) and from the German Federal Ministry of Education and Research (BMBF) to the German Center for Diabetes Research (DZD e. V.). The GDS is supported in part by funds of the BMBF to the DZD e. V. This project is also receiving funding from the programme “Profilbildung 2020”, an initiative of the Ministry of Culture and Science of the State of Northrhine-Westphalia. The sole responsibility for the content of this publication lies with the authors. M.R. is further supported by grants from the European Community (HORIZON-HLTH-2022-STAYHLTH-02-01: Panel A) to the INTERCEPT-T2D consortium, European Funds for Regional Development (EFRE-0400191), EUREKA Eurostars-2 (E!-113230-DIA-PEP), the German Science Foundation (DFG; RTG/GRK 2576) and the Schmutzler Stiftung. The sole responsibility for the content of this publication lies with the authors. V.S.-H. was supported by an European Research Council starting grant (759161 MRS in diabetes). The funding sources were not involved in the design of the study; the collection, analysis, and interpretation of data; writing the report; and did not impose any restrictions regarding the publication of the report.
Publisher Copyright:
© 2023 The Authors. Liver International published by John Wiley & Sons Ltd.
PY - 2024/1
Y1 - 2024/1
N2 - 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 1H-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.
AB - 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 1H-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.
KW - diabetes mellitus type 2
KW - humans
KW - non-alcoholic fatty liver
KW - thyroid diseases
KW - thyroxine
U2 - 10.1111/liv.15723
DO - 10.1111/liv.15723
M3 - Article
SN - 1478-3223
VL - 44
SP - 27
EP - 38
JO - Liver International
JF - Liver International
IS - 1
M1 - 15723
ER -