2型糖尿病合并非酒精性脂肪肝患者性激素与甲状腺激素水平变化及其临床意义

摘要/Abstract

摘要： 目的探讨2型糖尿病(T2DM)合并非酒精性脂肪性肝病(NAFLD)性激素及甲状腺激素水平的变化特点,并分析其与代谢及肝功能指标之间的关系。方法选取2023年1月至2025年5月肥东县中医医院就诊及体检者共122例,其中T2DM+NAFLD组42例、单纯NAFLD组24例、单纯T2DM组24例及健康对照组32例。比较各组一般资料、代谢指标、性激素及甲状腺激素水平。采用Spearman相关性分析探讨激素水平与体质指数、血糖控制及肝功能指标之间的相关性。结果与健康对照组相比,T2DM+NAFLD组BMI、空腹血糖(FBG)、糖化血红蛋白(HbA₁c)、转氨酶及甘油三酯(TG)水平均明显升高(P<0.05)。性激素检测结果显示,T2DM+NAFLD组总睾酮及性激素结合球蛋白(SHBG)水平显著低于其他各组(P<0.05),而雌二醇水平相对升高(P<0.05)。甲状腺激素方面,T2DM合并NAFLD组促甲状腺激素(TSH)升高、游离三碘甲状腺原氨酸(FT3)降低,而游离甲状腺素(FT4)无明显变化。相关性分析结果显示,总睾酮、SHBG及FT3水平均与BMI、HbA₁c、转氨酶及TG呈负相关,TSH水平与上述指标呈正相关。结论 T2DM合并NAFLD患者存在明显的性激素及甲状腺激素代谢异常,其变化与糖脂代谢紊乱及肝功能损害密切相关。

关键词: 2型糖尿病, 非酒精性脂肪肝, 性激素, 甲状腺激素

Abstract: Objective To investigate the patterns of sex hormone and thyroid hormone alterations in patients with T2DM complicated by NAFLD, and to examine their associations with metabolic and liver function indicators, thereby providing evidence for clinical assessment in this population. Methods A total of 122 individuals who attended outpatient clinics or underwent health examinations between January 2023 and May 2025 were enrolled in Feidong County Traditional Chinese Medicine Hospital. According to the presence of T2DM and NAFLD, participants were divided into four groups: T2DM with NAFLD (n=42), NAFLD alone (n=24), T2DM alone (n=24), and healthy controls (n=32). General clinical characteristics, metabolic parameters, and levels of sex hormones and thyroid hormones were compared among groups. Spearman correlation analysis was performed to assess the relationships between hormone levels and body mass index (BMI), glycemic control, and liver function indices. Results Compared with the healthy control group, patients in the T2DM with NAFLD group exhibited significantly higher BMI, fasting blood glucose, glycated hemoglobin, transaminase levels, and triglyceride concentrations (P<0.05). Sex hormone analysis revealed that total testosterone and sex hormone-binding globulin (SHBG) levels were significantly lower in the T2DM with NAFLD group than in the other groups (P<0.05), whereas estradiol levels were relatively elevated (P<0.05). With respect to thyroid function, patients with T2DM complicated by NAFLD showed increased thyroid-stimulating hormone (TSH) levels and decreased free triiodothyronine (FT3) levels, while free thyroxine (FT4) levels remained unchanged. Correlation analysis demonstrated that total testosterone, SHBG, and FT3 levels were negatively correlated with BMI, HbA₁c, transaminases, and triglycerides, whereas TSH levels were positively correlated with these parameters. Conclusion Patients with T2DM complicated by NAFLD exhibit marked disturbances in sex hormone and thyroid hormone metabolism, which are closely associated with disordered glucose and lipid metabolism and impaired liver function. Assessment of sex hormone and thyroid hormone levels may help provide a more comprehensive evaluation of metabolic status and offer useful information for the integrated clinical management of these patients.

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

柳钰涵, 张健, 王定远, 王勇. 2型糖尿病合并非酒精性脂肪肝患者性激素与甲状腺激素水平变化及其临床意义[J]. 肝脏, 2026, 31(7): 1020-1023.

Liu Yuhan, Zhang Jian, Wang Dingyuan, Wang Yong. Changes in sex hormone and thyroid hormone levels in patients with type 2 diabetes mellitus complicated by non-alcoholic fatty liver disease and their clinical significance[J]. Chinese Hepatolgy, 2026, 31(7): 1020-1023.

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