Diabetes, Metabolic Syndrome and Obesity (Nov 2020)

Elevated TPOAb is a Strong Predictor of Autoimmune Development in Patients of Type 2 Diabetes Mellitus and Non-Alcoholic Fatty Liver Disease: A Case–Control Study

  • Wang C,
  • Niu Q,
  • Lv H,
  • Li Q,
  • Ma Y,
  • Tan J,
  • Liu C

Journal volume & issue
Vol. Volume 13
pp. 4369 – 4378

Abstract

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Chenyi Wang,1,2,* Qianglong Niu,1,* Haihong Lv,1,* Qian Li,1 Yuping Ma,1 Jiaojiao Tan,1 Chunhua Liu1 1Department of Endocrinology, The First Hospital of Lanzhou University, Lanzhou, Gansu 730000, People’s Republic of China; 2Department of Endocrinology, The First Clinical Medical College of Lanzhou University, Lanzhou, Gansu, 730000, People’s Republic of China*These authors contributed equally to this workCorrespondence: Haihong Lv Department of EndocrinologyThe First Hospital of Lanzhou University, Lanzhou, Gansu 730000, People’s Republic of ChinaEmail [email protected]: The aim of this study was to assess the prevalence of thyroid autoimmunity in T2DM with NAFLD, furthermore explore the relationship between elevated TPOAb titer and the severity of NAFLD.Methods: A total of 400 patients with T2DM were divided into two groups according to NAFLD. Thyroid function and other metabolic indicators were measured.Results: There were more TPOAb-positive patients in both groups, and the prevalence of TPOAb positive was significantly different in two groups (17% vs 6.9%, p< 0.01). FT4 was significantly lower in patients with T2DM with NAFLD (median FT4 0.89 vs 1.08, p < 0.001), while TSH was increased (median TSH 2.85 vs 2.28, p < 0.05). In patients with T2DM with NAFLD, the proportion of women in the thyroid autoimmune-positive group was significantly higher than the negative (71.1% vs 46%, p < 0.01). Similarly, thyroid autoimmune-positive T2DM and NAFLD patients had lower FT4 levels (median FT4 0.59 vs 0.92, p < 0.001), higher TSH levels (median TSH 3.65 vs 2.67, p < 0.001), and much higher TPOAb/TGAb (median TPOAb/TGAb 6.8 vs 1.46, p < 0.001). The increase of TPOAb was significantly correlated with the severity of fatty liver. HbA1c, TC, TG, TSH, TPOAb/TGAb and severity of fatty liver were risk factors of thyroid autoimmunity.Conclusion: Autoimmune thyroid disease is more common in patients with T2DM complicated with NAFLD. Elevated TPOAb titer is closely related to fatty liver, suggesting that elevated TPOAb titer is a predictor of autoimmune development in T2DM with NAFLD.Keywords: type 2 diabetes mellitus, non-alcoholic fatty liver disease, thyroid peroxidase antibody, thyroglobulin antibody, autoimmune thyroid disease

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