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投稿时间：2024-11-27 网络发布日期：2025-11-26
投稿时间：2024-11-27 网络发布日期：2025-11-26
中文摘要: 目的 探究自身免疫性肝病（AILD）患者胆汁酸代谢组分和甲状腺功能指标的相关性。方法 纳入2020年1月至2024年3月南京市第二医院收治的219例AILD患者为研究对象，其中自身免疫性肝炎（AIH）患者98例（AIH组），原发性胆汁性胆管炎（PBC）患者121例（PBC组），另根据性别和年龄匹配原则，选取同期健康体检者90例作为对照组。比较各组间血清生化指标、甲状腺激素和胆汁酸构成组分水平的差异，进一步进行指标间的相关性分析。结果 在15种检测的胆汁酸代谢产物中，除胆酸（CA）、鹅脱氧胆酸（CDCA）和脱氧胆酸（DCA）外，AIH组和PBC组的其他12种胆汁酸组分浓度均显著升高（P<0.05），PBC组的熊脱氧胆酸（UD-CA）、甘氨胆酸（GCA）、甘氨熊脱氧胆酸（GUDCA）、牛磺胆酸（TCA）和牛磺熊脱氧胆酸（TUDCA）浓度比AIH组显著升高（P<0.05）。在甲状腺功能指标中，AIH组和PBC组的三碘甲状腺原氨酸（T3）、甲状腺素（T4）、游离三碘甲状腺原氨酸（FT3）和游离甲状腺素（FT4）水平显著低于健康组（P<0.05），甲状腺过氧化物酶抗体（TPOAb）水平显著高于健康组（P<0.05），促甲状腺激素（TSH）和甲状腺球蛋白抗体（TGAb）水平三组间差异无统计学意义（P>0.05）。Spearman 相关性分析显示，PBC 组的 FT4 与 CA 负相关（r=-0.810，P=0.008），TPOAb 与CDCA（r=0.373，P=0.003）和 UDCA（r=0.412，P=0.001）正相关。AIH 组的 T3 与牛磺脱氧胆酸（TDCA）负相关
（r=-0.234，P=0.043），T4与牛磺鹅脱氧胆酸（TCDCA）（r=-0.251，P=0.029）和CDCA（r=-0.232，P=0.043）负相关，FT3与甘氨鹅脱氧胆酸（GCDCA）（r=-0.247，P=0.026）和TCDCA（r=-0.229，P=0.040）负相关，与牛磺石胆酸（TLCA）（r=0.232，P=0.037）正相关，TPOAb与DCA（r=0.311，P=0.028）正相关。结论 AILD引起患者胆汁酸代谢紊乱和甲状腺功能异常，甲状腺功能指标与部分胆汁酸浓度相关联。
Abstract:Objective To explore the correlation between bile acid metabolic components and thyroid function indicators in patients with autoimmune liver disease（AILD）. Methods A total of 219 AILD patients admitted to the Second Hospital of Nanjing from January 2020 to March 2024 were included，including 98 patients with autoimmune hepatitis（AIH）and 121 patients with primary biliary cholangitis（PBC）. In addition，according to the principle of gender and age matching，90 healthy individuals who underwent physical examinations during the same period were selected as the control group. The differences in levels of serum biochemical data，thyroid hormone，and bile acid components among three groups were compared，and the correlation between the indexes was analyzed. Results Among the 15 detected bile acid metabolites，except for cholic acid（CA），chenodeoxycholic acid（CDCA），and deoxycholic acid（DCA），the concentrations of the other 12 bile acid components in AIH group and PBC group were significantly increased（P<0.05），and the concentrations of ursodeoxycholic acid（UDCA），glycocholic acid（GCA），glycoursodeoxycholic acid（GUDCA），taurocholic acid（TCA），and tauroursodeoxycholic acid（TUDCA）in PBC group were significantly higher than those in AIH group（P<0.05）. Among thyroid function indicators，the levels of triiodothyronine（T3），thyroxine（T4），free triiodothyronine（FT3），and free thyroxine（FT4）in AIH group and PBC group were significantly lower than those in healthy group（P<0.05），and the level of thyroid peroxidase antibodies（TPOAb）was significantly higher than that in healthy group（P<0.05），but there were no statistically significant difference in the levels of thyroid stimulating hormone（TSH）and thyroglobulin antibodies（TGAb）among three groups（P>0.05）. Spearman correlation analysis showed that in PBC group，FT4 was negatively correlated with CA（r=- 0.810，P=0.008），and TPOAb was positively correlated with CDCA （r=0.373，P=0.003） and UDCA（r=0.412，P=0.001）. In AIH group，T3 was negatively correlated with taurodeoxycholic acid（TDCA）（r=-0.234，P=0.043），T4 was negatively correlated with taurochenodeoxycholic acid（TCDCA）（r=-0.251，P = 0.029）and CDCA（r=-0.232，P = 0.043），FT3 was negatively correlated with glycochenodeoxycholic acid（GCDCA）（r=- 0.247，P = 0.026）and TCDCA（r=- 0.229，P=0.040），while positively correlated with taurolithocholic acid（TLCA）（r=0.232，P=0.037），TPOAb was positively correlated with DCA（r=0.311，P=0.028）. Conclusion AILD can cause serum bile acid metabolism disorders and thyroid function abnormalities in patients，and thyroid function indicators are associated with the concentrations of some bile acids.
文章编号： 中图分类号：R593.2 R575 文献标志码：A
基金项目:江苏省研究生科研与实践创新计划（SJCX23_0855）
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引用文本：
宋克玉，乔润洁，王雯菁，张琴，谈国蕾.自身免疫性肝病患者胆汁酸谱和甲状腺功能的相关性分析[J].中国临床研究,2025,38(11):1700-1704.
宋克玉，乔润洁，王雯菁，张琴，谈国蕾.自身免疫性肝病患者胆汁酸谱和甲状腺功能的相关性分析[J].中国临床研究,2025,38(11):1700-1704.