Yuhan Wang, Jicheng Xie, Yan Wang, Xingning Liu, Xiaozhou Zhou
Age played a major role in explaining the inverse correlation between TFQI and FIB-4 in patients with MASLD alone in this exploratory study. These results should be considered hypothesis-generating and should be validated in bigger prospective trials with direct measurements of fibrosis. Future research may benefit from the heterogeneous associations across metabolic backgrounds.
BACKGROUND: Metabolic Dysfunction-associated Steatotic Liver Disease (MASLD) frequently coexists with Type 2 Diabetes Mellitus (T2DM) and Primary Hypothyroidism (PH); nevertheless, the relationship between thyroid hormone sensitivity and FIB-4-defined fibrosis risk across these metabolic diseases is yet unknown.
METHODS: In 102 patients with MASLD, MASLD+T2DM, and MASLD+T2DM+treated PH (34 per group), this exploratory cross-sectional study examined the association between the Thyroid Feedback Quantile Index (TFQI) and the Fibrosis-4 Index (FIB-4). The cumulative distribution functions of TSH and FT4 were used to calculate TFQI. A surrogate indicator of the risk of fibrosis was FIB-4. G*Power 3.1.9.7 was used for post-hoc power analysis after multivariable regression and correlation analyses were completed.
RESULTS: In the MASLD-alone group, TFQI and FIB-4 had a significant inverse correlation in unadjusted analysis (r = -0.384, P = 0.025). Nevertheless, after controlling for age, sex, and BMI, this link was diminished and no longer significant (β = -0.195, P = 0.073). The most powerful independent predictor of FIB-4 was age (β = 0.704, P < 0.001). Age significantly confounded the association, according to sensitivity analyses such as age-adjusted partial correlation, FIB-4 component analysis, and FIB-4 category analysis. In the other two groups, no noteworthy correlations were found.
CONCLUSIONS: Age played a major role in explaining the inverse correlation between TFQI and FIB-4 in patients with MASLD alone in this exploratory study. These results should be considered hypothesis-generating and should be validated in bigger prospective trials with direct measurements of fibrosis. Future research may benefit from the heterogeneous associations across metabolic backgrounds.