---
title: "Thyroid Function and MAFLD in Type 2 Diabetes: Case-Control Study of FT3 and TSH Associations"
id: "pubmed-42664128"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42664128"
content_type: "clinical_feed_article"
specialty: "Endocrinology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42664128/"
doi: "10.7417/CT.2026.2108"
published_at: "2026-09-01T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Thyroid Function and MAFLD in Type 2 Diabetes: Case-Control Study of FT3 and TSH Associations
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42664128
- **Specialty:** [Endocrinology](https://medichelpline.com/clinical-feed/endocrinology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42664128/)
- **DOI:** [10.7417/CT.2026.2108](https://doi.org/10.7417%2FCT.2026.2108)
- **Published At:** 2026-09-01T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- Metabolic dysfunction-associated fatty liver disease (**MAFLD**) is common in patients with **type 2 diabetes mellitus (T2DM)** and is linked to insulin resistance and dyslipidemia. - This case-control study enrolled 150 patients with T2DM: 75 with MAFLD and 75 without MAFLD. - Hepatic steatosis was diagnosed using transient elastography with the controlled attenuation parameter (**CAP**). - Serum thyroid tests measured included **free triiodothyronine (FT3)**, **free thyroxine (FT4)**, and **thyroid-stimulating hormone (TSH)**, using chemiluminescent immunoassays. - Patients with MAFLD had significantly lower **FT3** and higher **TSH** compared with diabetic controls without MAFLD (p = 0.016 and p < 0.001, respectively); **FT4** did not differ between groups. - MAFLD cases demonstrated an adverse metabolic profile with higher triglycerides, total cholesterol, and LDL cholesterol and lower HDL cholesterol (all p < 0.001). - Liver enzymes were reported as significantly different between groups in the abstract, but the specific enzyme values and statistics were not fully provided in the source text. - Multivariate logistic regression was used to identify independent predictors of MAFLD, but the abstract truncates before reporting which variables remained independent predictors. - The findings suggest an association between altered thyroid function—specifically lower FT3 and higher TSH—and MAFLD in people with T2DM, with implications for metabolic risk characterization. - Several methodological details and full result data (exact liver enzyme levels, regression model outputs, and effect sizes) were not reported in the provided source excerpt.
## Clinical Analysis & Structured Key Points
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more resources ](https://pubmed.ncbi.nlm.nih.gov/42664128/#linkout) Title & authors Abstract Similar articles Publication types MeSH terms Substances Related information LinkOut - more resources Observational Study Clin Ter Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Clin+Ter%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Clin+Ter%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42664128/) . 2026 Sep-Oct;177(5):1079-1085. doi: 10.7417/CT.2026.2108. # Association Between Thyroid Function and Metabolic Dysfunction-Associated Fatty Liver Disease in Patients with Type 2 Diabetes Mellitus: A Case-Control Study [Ihab Anwar Orabi](https://pubmed.ncbi.nlm.nih.gov/?term=Orabi+IA&cauthor_id=42664128)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42664128/#full-view-affiliation-1 "Department of Internal Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt."), [Ahmed A Elhadidy](https://pubmed.ncbi.nlm.nih.gov/?term=Elhadidy+AA&cauthor_id=42664128)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42664128/#full-view-affiliation-2 "Department of Internal Medicine, Faculty of Medicine, Tanta university, Tanta, Egypt."), [Ola Abd Elfattah Ali Amro](https://pubmed.ncbi.nlm.nih.gov/?term=Amro+OAEA&cauthor_id=42664128)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42664128/#full-view-affiliation-3 "Geriatric Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt."), [Asmaa A Attia](https://pubmed.ncbi.nlm.nih.gov/?term=Attia+AA&cauthor_id=42664128)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42664128/#full-view-affiliation-4 "Department of Internal Medicine, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt."), [Amr A Abdelkader](https://pubmed.ncbi.nlm.nih.gov/?term=Abdelkader+AA&cauthor_id=42664128)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42664128/#full-view-affiliation-5 "Department of Diagnostic and Interventional Radiology and Molecular Imaging, Faculty of Medicine, Ain Shams University, Cairo, Egypt."), [Elham Shabaan Mohamed](https://pubmed.ncbi.nlm.nih.gov/?term=Mohamed+ES&cauthor_id=42664128)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42664128/#full-view-affiliation-6 "Department of Internal medicine and Rheumatology, Faculty of Medicine, Ain Shams University, Cairo, Egypt."), [Mohammad Mossaad Abd Allah Alsayyad](https://pubmed.ncbi.nlm.nih.gov/?term=Alsayyad+MMAA&cauthor_id=42664128)[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42664128/#full-view-affiliation-7 "Internal Medicine Department, Faculty of Medicine, Al-Azhar University, New Damietta, Egypt."), [Ahmed Fakeih Sakr Elfors](https://pubmed.ncbi.nlm.nih.gov/?term=Sakr+Elfors+AF&cauthor_id=42664128)[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42664128/#full-view-affiliation-8 "Department of Hepatology, Gastroenterology and infectious diseases faculty of medicine, Al-Azhar university, Egypt."), [Marian Wagieh Mansour Abdelmalak](https://pubmed.ncbi.nlm.nih.gov/?term=Abdelmalak+MWM&cauthor_id=42664128)[ 9 ](https://pubmed.ncbi.nlm.nih.gov/42664128/#full-view-affiliation-9 "Department of Geriatrics and Gerontology, Faculty of Medicine, Ain Shams University, Cairo, Egypt."), [Sherif Mohamed Elsayed Amin Hegab](https://pubmed.ncbi.nlm.nih.gov/?term=Hegab+SMEA&cauthor_id=42664128)[ 10 ](https://pubmed.ncbi.nlm.nih.gov/42664128/#full-view-affiliation-10 "Fellow of Hepatology, Gastroenterology and Infectious Diseases, Ahmed Maher Teaching Hospital, Cairo, Egypt."), [Tamer Hassan Rashwan](https://pubmed.ncbi.nlm.nih.gov/?term=Rashwan+TH&cauthor_id=42664128)[ 11 ](https://pubmed.ncbi.nlm.nih.gov/42664128/#full-view-affiliation-11 "Department of Internal Medicine, faculty of Medicine, Al-Azhar University, Assiut, Egypt."), [Hatem Attia Mostafa Ismail](https://pubmed.ncbi.nlm.nih.gov/?term=Ismail+HAM&cauthor_id=42664128)[ 12 ](https://pubmed.ncbi.nlm.nih.gov/42664128/#full-view-affiliation-12 "Department of Clinical Pathology, National Liver Institute, Menoufia University, Shebin Elkom, Egypt."), [Hanan A Hegazy](https://pubmed.ncbi.nlm.nih.gov/?term=Hegazy+HA&cauthor_id=42664128)[ 13 ](https://pubmed.ncbi.nlm.nih.gov/42664128/#full-view-affiliation-13 "Environmental and Occupational Medicine Department, National Research Centre, Giza, Egypt."), [S A Mashaal](https://pubmed.ncbi.nlm.nih.gov/?term=Mashaal+SA&cauthor_id=42664128)[ 14 ](https://pubmed.ncbi.nlm.nih.gov/42664128/#full-view-affiliation-14 "Department of Tropical Medicine and Infectious diseases, Faculty of Medicine, Tanta University, Tanta, Egypt.") Affiliations Expand ### Affiliations * 1 Department of Internal Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt. * 2 Department of Internal Medicine, Faculty of Medicine, Tanta university, Tanta, Egypt. * 3 Geriatric Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt. * 4 Department of Internal Medicine, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt. * 5 Department of Diagnostic and Interventional Radiology and Molecular Imaging, Faculty of Medicine, Ain Shams University, Cairo, Egypt. * 6 Department of Internal medicine and Rheumatology, Faculty of Medicine, Ain Shams University, Cairo, Egypt. * 7 Internal Medicine Department, Faculty of Medicine, Al-Azhar University, New Damietta, Egypt. * 8 Department of Hepatology, Gastroenterology and infectious diseases faculty of medicine, Al-Azhar university, Egypt. * 9 Department of Geriatrics and Gerontology, Faculty of Medicine, Ain Shams University, Cairo, Egypt. * 10 Fellow of Hepatology, Gastroenterology and Infectious Diseases, Ahmed Maher Teaching Hospital, Cairo, Egypt. * 11 Department of Internal Medicine, faculty of Medicine, Al-Azhar University, Assiut, Egypt. * 12 Department of Clinical Pathology, National Liver Institute, Menoufia University, Shebin Elkom, Egypt. * 13 Environmental and Occupational Medicine Department, National Research Centre, Giza, Egypt. * 14 Department of Tropical Medicine and Infectious diseases, Faculty of Medicine, Tanta University, Tanta, Egypt. * PMID: **42664128** * DOI: [ 10.7417/CT.2026.2108 ](https://doi.org/10.7417/ct.2026.2108) Free article Item in Clipboard Observational Study # Association Between Thyroid Function and Metabolic Dysfunction-Associated Fatty Liver Disease in Patients with Type 2 Diabetes Mellitus: A Case-Control Study Ihab Anwar Orabi et al. Clin Ter. 2026 Sep-Oct. Free article Show details Display options Display options Format Abstract PubMed PMID Clin Ter Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Clin+Ter%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Clin+Ter%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42664128/) . 2026 Sep-Oct;177(5):1079-1085. doi: 10.7417/CT.2026.2108. ### Authors [Ihab Anwar Orabi](https://pubmed.ncbi.nlm.nih.gov/?term=Orabi+IA&cauthor_id=42664128)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42664128/#short-view-affiliation-1 "Department of Internal Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt."), [Ahmed A Elhadidy](https://pubmed.ncbi.nlm.nih.gov/?term=Elhadidy+AA&cauthor_id=42664128)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42664128/#short-view-affiliation-2 "Department of Internal Medicine, Faculty of Medicine, Tanta university, Tanta, Egypt."), [Ola Abd Elfattah Ali Amro](https://pubmed.ncbi.nlm.nih.gov/?term=Amro+OAEA&cauthor_id=42664128)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42664128/#short-view-affiliation-3 "Geriatric Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt."), [Asmaa A Attia](https://pubmed.ncbi.nlm.nih.gov/?term=Attia+AA&cauthor_id=42664128)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42664128/#short-view-affiliation-4 "Department of Internal Medicine, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt."), [Amr A Abdelkader](https://pubmed.ncbi.nlm.nih.gov/?term=Abdelkader+AA&cauthor_id=42664128)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42664128/#short-view-affiliation-5 "Department of Diagnostic and Interventional Radiology and Molecular Imaging, Faculty of Medicine, Ain Shams University, Cairo, Egypt."), [Elham Shabaan Mohamed](https://pubmed.ncbi.nlm.nih.gov/?term=Mohamed+ES&cauthor_id=42664128)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42664128/#short-view-affiliation-6 "Department of Internal medicine and Rheumatology, Faculty of Medicine, Ain Shams University, Cairo, Egypt."), [Mohammad Mossaad Abd Allah Alsayyad](https://pubmed.ncbi.nlm.nih.gov/?term=Alsayyad+MMAA&cauthor_id=42664128)[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42664128/#short-view-affiliation-7 "Internal Medicine Department, Faculty of Medicine, Al-Azhar University, New Damietta, Egypt."), [Ahmed Fakeih Sakr Elfors](https://pubmed.ncbi.nlm.nih.gov/?term=Sakr+Elfors+AF&cauthor_id=42664128)[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42664128/#short-view-affiliation-8 "Department of Hepatology, Gastroenterology and infectious diseases faculty of medicine, Al-Azhar university, Egypt."), [Marian Wagieh Mansour Abdelmalak](https://pubmed.ncbi.nlm.nih.gov/?term=Abdelmalak+MWM&cauthor_id=42664128)[ 9 ](https://pubmed.ncbi.nlm.nih.gov/42664128/#short-view-affiliation-9 "Department of Geriatrics and Gerontology, Faculty of Medicine, Ain Shams University, Cairo, Egypt."), [Sherif Mohamed Elsayed Amin Hegab](https://pubmed.ncbi.nlm.nih.gov/?term=Hegab+SMEA&cauthor_id=42664128)[ 10 ](https://pubmed.ncbi.nlm.nih.gov/42664128/#short-view-affiliation-10 "Fellow of Hepatology, Gastroenterology and Infectious Diseases, Ahmed Maher Teaching Hospital, Cairo, Egypt."), [Tamer Hassan Rashwan](https://pubmed.ncbi.nlm.nih.gov/?term=Rashwan+TH&cauthor_id=42664128)[ 11 ](https://pubmed.ncbi.nlm.nih.gov/42664128/#short-view-affiliation-11 "Department of Internal Medicine, faculty of Medicine, Al-Azhar University, Assiut, Egypt."), [Hatem Attia Mostafa Ismail](https://pubmed.ncbi.nlm.nih.gov/?term=Ismail+HAM&cauthor_id=42664128)[ 12 ](https://pubmed.ncbi.nlm.nih.gov/42664128/#short-view-affiliation-12 "Department of Clinical Pathology, National Liver Institute, Menoufia University, Shebin Elkom, Egypt."), [Hanan A Hegazy](https://pubmed.ncbi.nlm.nih.gov/?term=Hegazy+HA&cauthor_id=42664128)[ 13 ](https://pubmed.ncbi.nlm.nih.gov/42664128/#short-view-affiliation-13 "Environmental and Occupational Medicine Department, National Research Centre, Giza, Egypt."), [S A Mashaal](https://pubmed.ncbi.nlm.nih.gov/?term=Mashaal+SA&cauthor_id=42664128)[ 14 ](https://pubmed.ncbi.nlm.nih.gov/42664128/#short-view-affiliation-14 "Department of Tropical Medicine and Infectious diseases, Faculty of Medicine, Tanta University, Tanta, Egypt.") ### Affiliations * 1 Department of Internal Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt. * 2 Department of Internal Medicine, Faculty of Medicine, Tanta university, Tanta, Egypt. * 3 Geriatric Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt. * 4 Department of Internal Medicine, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt. * 5 Department of Diagnostic and Interventional Radiology and Molecular Imaging, Faculty of Medicine, Ain Shams University, Cairo, Egypt. * 6 Department of Internal medicine and Rheumatology, Faculty of Medicine, Ain Shams University, Cairo, Egypt. * 7 Internal Medicine Department, Faculty of Medicine, Al-Azhar University, New Damietta, Egypt. * 8 Department of Hepatology, Gastroenterology and infectious diseases faculty of medicine, Al-Azhar university, Egypt. * 9 Department of Geriatrics and Gerontology, Faculty of Medicine, Ain Shams University, Cairo, Egypt. * 10 Fellow of Hepatology, Gastroenterology and Infectious Diseases, Ahmed Maher Teaching Hospital, Cairo, Egypt. * 11 Department of Internal Medicine, faculty of Medicine, Al-Azhar University, Assiut, Egypt. * 12 Department of Clinical Pathology, National Liver Institute, Menoufia University, Shebin Elkom, Egypt. * 13 Environmental and Occupational Medicine Department, National Research Centre, Giza, Egypt. * 14 Department of Tropical Medicine and Infectious diseases, Faculty of Medicine, Tanta University, Tanta, Egypt. * PMID: **42664128** * DOI: [ 10.7417/CT.2026.2108 ](https://doi.org/10.7417/ct.2026.2108) Item in Clipboard Full text links Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Background:** Metabolic dysfunction-associated fatty liver disease (MAFLD) is highly prevalent among patients with type 2 diabetes mellitus (T2DM) and is closely linked to metabolic disturbances such as insulin resistance and dyslipidemia. Thyroid hormones play a critical role in regulating hepatic lipid metabolism and energy homeostasis; however, their relationship with MAFLD in diabetic populations remains incompletely defined. **Methods:** In this case-control study, 150 patients with T2DM were enrolled, including 75 patients with MAFLD and 75 without MAFLD. Hepatic steatosis was confirmed using transient elastography with controlled attenuation parameter (CAP). Serum free triiodothyronine (FT3), free thyroxine (FT4), and thyroid-stimulating hormone (TSH) were measured using chemiluminescent immunoassays. Clinical, anthropometric, and biochemical parameters were assessed. Multivariate logistic regression analysis was performed to identify independent predictors of MAFLD. **Results:** Patients with MAFLD had significantly lower FT3 levels and higher TSH levels compared with diabetic controls without MAFLD (p = 0.016 and p < 0.001, respectively), while FT4 levels were comparable between groups. MAFLD was also associated with an adverse metabolic profile, including elevated triglycerides, total cholesterol, and low-density lipoprotein cholesterol, along with reduced high-density lipoprotein cholesterol (all p < 0.001). Liver enzymes were significantly h
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