| Objectives:Through the assay of not only serum thyroid hormones, including 3,5,3,-triiodothyronine (TT3), 3,5,3,5,-tetraiodothyronine (TT4), 3,3,5,-triiodothyronine (rT3) and thyroid stimulating hormone (TSH), but blood lipid (triglyceride, total cholesterin, high density lipoprotein-cholesterol, low density lipoprotein-cholesterol ) , hepatic function, insulin ,and serum markers of hepatic fibrosis, such as hyaluronic acid (HA), amino terminal procollagen typeⅢpeptide (PⅢNP),1aminin (LN),collagen typeⅣ(CⅣ) in patient with non-alcoholic fatty liver disease (NAFLD), the serum levels of thyroid hormones were explored, and the relationship between it and clinical classification of NAFLD, hepatic function,hepatic fibrosis and insulin resistance were analysed too. Meanwhile, the effect of thyroid hormones in the development of NAFLD was studied. It was designed to provide novel methods and directions for treatment and prevention of NAFLD.Methods:Case control study was adopted according to the standard of case entry and removal. The 123 patients that were diagnosed NAFLD were selected strictly. Based on the criteria of clinical classification, the 123 subjects were divided into non-alcoholic simple fatty liver (NASFL) group (83) and non-alcoholic steatohepatitis (NASH) group (40). And all NAFLD patients were divided into mild group(58), moderate group(48) and severe group(23) according to the criteria of type-B ultrasonic. At the same time, 56 normal controls were chose from the healthy people, and case group and control group were matched in age and sex. Data of research object including body height, body weight and blood pressure was measured by standard method. After 12 hours fasting diet, 8ml venous blood sample was drown and poured into 2 tubes separately. One was used to determine blood biochemical indicator by immunoturbidimetry and detect serum hepatitis markers with enzyme-labeled immunosorbent assay ( ELISA). The other was centrifugated, and then the serum was in EP tube and stored in -20℃refrigerator for the detection of thyroid hormones (TT3, TT4, rT3 and TSH), insulin and the serum markers of hepatic fibrosis (HA, PⅢNP, LN and CⅣ)using radio-immunity assay.All the data were entered into the computer in Excel 2003 and analyzed with SPSS 11.5 software. Measurement data were expressed as mean±standard deviation ((x|-)±s), the comparison between two groups were analyzed by T test, and the comparison of mean variability among multiple groups was conducted with one-way ANOVA analysis and the LSD test. The numeration data were analyzed by Chi-square test. The correlation of bivariate was analyzed with Pearson's correlation analysis. If P<0.05, the result was considered statistical significance.Results:1.The serum levels of HA , PⅢNP, CⅣ, LN and levels of blood lipid were significantly higher in NAFLD group than those in control group, P<0.05.2. The serum level of TT3 increased obviously and the serum level of rT3 decreased significantly in NAFLD patients compared with control group, P<0.05. There were no significant differences in the serum levels of TT4 and TSH between NAFLD group and control group, P>0.05.3. The serum level of TT3 was significantly lower and the serum level of rT3 was markedly higher in NASH group than those in NASFL group, P<0.05.4. With the increase level of ALT, the serum level of TT3 decreased gradually, while the serum level of rT3 increased gradually in NAFLD patients, P<0.05.5. There were a gradual decreased serum level of TT3 and increased serum level of rT3 with the increase level of HA in NAFLD patients, P<0.05.6. The serum level of TT3 was negatively correlated with the indicators to reflect hepatic fibrosis (HA, PⅢNP, LN, CⅣ) and demonstrate liver cell damage (ALT and AST), and had a positive correlation with the serum albumin in NAFLD patients, P<0.05.Conclusions:1. There is a decreased serum TT3 level and a increased serum rT3 level in NAFLD patients.2.The decreased serum TT3 level and the increased serum rT3 are consistent with the severity of NAFLD and the elevated level of serum markers of hepatic fibrosis in NAFLD patients. |
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