Association Between Sensitivity to Thyroid Hormones and Metabolic Dysfunction-Associated Fatty Liver Disease in Euthyroid Subjects: A Cross-Sectional Study

Abstract

Thyroid hormones (THs) exert instrumental effects in regulating lipids metabolism. Whereas, research investigating the relationship between sensitivity indices to THs and metabolic dysfunction-associated fatty liver disease (MAFLD) have contradicted this. This study was designed to approach the correlation between sensitivity indices to THs and MAFLD in euthyroid subjects. Methods: An overall sample of 6356 euthyroid participants were enrolled in a Chinese hospital. Free triiodothyronine to free thyroxine ratio (FT3/FT4), thyrotropin triiodothyronine resistance index (TT3RI), thyrotropin thyroxine resistance index (TT4RI), thyroid stimulating hormone index (TSHI) and thyroid feedback quantile-based indices (TFQI FT3 and TFQI FT4 ) were collected as sensitivity indicators to THs. Participants were split into two groups based on whether they suffered with MAFLD or not. And participants were categorized into quartiles based on sensitivity indicators to THs. The effects of sensitivity indices to THs on MAFLD were analyzed using regression analysis. Bootstrap was performed to assess the mediation effect of triglyceride glucose (TyG) index on the relationship between sensitivity parameters to THs and MAFLD. Results: The incidence of MAFLD in euthyroid subjects was 34.47%. As FT3/FT4, TT3RI and TFQI FT3 levels rose, so did the MAFLD prevalence. After adjustment for confounders, logistic regression analyses indicated that the high-level FT3/FT4 and TFQI FT3 still remained risk factors for MAFLD. The relevance of FT3/FT4 and MAFLD was stronger among those whose age ≤ 40 years and had nonvisceral obesity. And the interrelation between TFQI FT3 and MAFLD was stronger in subjects whose age ≤ 40 years. Mediation analyses suggested that TyG index had a noteworthy indirect impact on the relationship between FT3/FT4, TFQI FT3 and MAFLD. Conclusion: Increased FT3/FT4 and TFQI FT3 were significantly related to MAFLD prevalence in populations with normal thyroid function. TyG index partly mediated the relevance between FT3/FT4, TFQI FT3 and MAFLD.

Metabolic Dysfunction–Associated Fatty Liver Disease (MAFLD) and Thyroid Function in Childhood Obesity: A Vicious Circle?

“…Liu H, 2023 [111] Cross-Sectional Study 6356 euthyroid adults, 2191/6356 with MAFLD Elevated levels of FT3/FT4 and TFQIFT3 were significantly associated with the prevalence of MAFLD in euthyroid populations. The TyG index partially mediated the relationship between FT3/FT4, TFQIFT3, and MAFLD.…”

“…Even in an euthyroid population, Liu H. et al found that MAFLD prevalence was 34.47%. This research study showed that the MAFLD group was characterized by a higher total triiodothyronine resistance index (TT3RI), thyroid feedback quantile-based index (TFQI)FT3, and FT3/FT4 levels in comparison with the non-MAFLD group, where TT3RI stands for fT3/TSH; TFQIFT3 stands for the thyroid feedback quantile-based index (TFQI)] = fT3 − (1-TSH), underlining the bond between hypothyroidism and MAFLD [111].…”

Association Between Sensitivity to Thyroid Hormones and Metabolic Dysfunction-Associated Fatty Liver Disease in Euthyroid Subjects: A Cross-Sectional Study [Letter]

“…Recently, Liu et al published an original article titled “Association Between Sensitivity to Thyroid Hormones and Metabolic Dysfunction-Associated Fatty Liver Disease in Euthyroid Subjects: A Cross-Sectional Study” in Diabetes, Metabolic Syndrome and Obesity-Targets and Therapy. 1 Since we are undertaking a pertinent longitudinal cohort study, we are highly interested in this article. We appreciate the authors for their work and congratulate them on their successes.…”

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in Diabetes, Metabolic Syndrome and Obesity-Targets and Therapy. 1 Since we are undertaking a pertinent longitudinal cohort study, we are highly interested in this article. We appreciate the authors for their work and congratulate them on their successes.This study focused primarily on the current hotspot of metabolic dysfunction-associated fatty liver disease (MAFLD) and explored the relationship between thyroid hormone and MAFLD.

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Interaction between triglyceride-glucose index and thyroid hormones on coronary artery disease risk in patient with euthyroid

“…Low free triiodothyronine (FT3) level was negatively associated with the severity of CAD in euthyroid individuals ( 9 ). The TyG index, as an effective indicator of metablic syndrome, has been proven to be related to THs and THs sensitivity ( 10 ). Previous studies also investigated the relationship between THs and TyG index in non-diabetic adults and showed TyG index was negatively associated with FT4 level, positively associated with TSH level ( 11 ).…”