Association between Thyroid-Stimulating Hormone Levels and Non-Alcoholic Fatty Liver Disease Is Not Independent from Metabolic Syndrome Criteria

Abstract

Introduction: Thyroid hormones are involved in the regulation of body composition, lipid metabolism, and insulin resistance. Thus, it is possible that they might play a role in the pathogenesis of non-alcoholic fatty liver disease (NAFLD). However, the role of thyroid function on NAFLD is not well defined. In this study, we evaluated the relationship between thyroid-stimulating hormone (TSH) levels, within the reference range, and presence of NAFLD in asymptomatic individuals. Study Design: We included all individuals evaluated at a preventive clinic of the Hospital Israelita Albert Einstein, between 2014 and 2015. The prevalence of NAFLD (analyzed by abdominal ultrasound), according to TSH quartiles, within the reference range, was determined. The association between TSH quartiles and NAFLD was analyzed by logistic regression adjusted for possible confounders. ­Results: We evaluated 10,539 individuals (73% male, age 43.4 ± 9.4 years). The prevalence of NAFLD was 34, 38, 38, and 39% in the first to the fourth TSH quartiles (0.46–1.44, 1.45–1.97, 1.98–2.68, and 2.69–4.68 mUI/L, respectively, p for trend < 0.001). At univariate analysis, higher TSH levels were associated with the diagnosis of NAFLD. When data were adjusted for the metabolic syndrome characteristics (waist circumference, HDL-cholesterol and triglycerides levels, presence of diabetes, and systemic arterial hypertension), the association was no longer significant. Conclusions: Although the TSH variability within the reference range is associated with NAFLD in univariable models, once adjusted for metabolic syndrome factors no significant association is noted.

The Role of Thyroid Hormones and Autoantibodies in Metabolic Dysfunction Associated Fatty Liver Disease: TgAb May Be a Potential Protective Factor

“…What’s more, results in a large longitudinal cohort study showed that the correlation of TSH with MAFLD was not independent of cardiometabolic confounders ( 32 ). Another study involving 10,539 individuals suggested that the association between TSH and MAFLD was mediated by the characteristics of MetS (waist circumference, HDL levels, triglycerides levels, DM, and systemic arterial hypertension) ( 33 ). Notably, an inverse correlation between FT4 level and risk were found in some studies ( 12 , 29 , 34 ).…”

Gestational hypothyroidism elicits more pronounced lipid dysregulation in mice than pre-pregnant hypothyroidism

“…HYPOTHYROIDISM is a metabolic disease which is characterized by low level of thyroid hormone (TH) and high level of thyroid-stimulating hormone in serum [1]. TH plays an important role in regulating lipid and glucose metabolism and insulin signaling [2][3][4]. According to previous literature, TH stimulates cholesterol and other lipid synthesis, increases mobilization of plasma cholesterol and triglycerides (TG) [5][6][7].…”

Unraveling the Role of Hypothyroidism in Non-alcoholic Fatty Liver Disease Pathogenesis: Correlations, Conflicts, and the Current Stand

“…After applying inclusion and exclusion criteria, 44 full-text articles were found to be potentially eligible. Of these, 10 articles [ 15 - 24 ] were identified as suitable to the aims of our research question and met the quality specifications necessary for this systematic review.…”

“…All of these studies were published between 2011 and 2021. The following studies were included: Janovsky et al [ 15 ], Tahara et al [ 16 ], Wang et al [ 17 ], Bano et al [ 18 ], Eshraghian et al [ 19 ], Gökmen et al [ 20 ], Lee et al [ 21 ], Ludwig et al [ 22 ], Mazo et al [ 23 ], and Shi et al [ 24 ]. Five of these studies were conducted in Asia, two in South America, two in Europe, and one in the Middle East.…”

“…Out of 10 studies, nine [ 15 - 22 , 24 ] evaluated the association between TSH levels and NAFLD risk. Janovsky et al [ 15 ] detected that among euthyroid individuals, higher TSH values were associated with higher NAFLD prevalence (OR = 1.22; p < 0.01) after adjusting for age and gender. However, this association became insignificant (OR = 0.93; p = 0.20) when additionally adjusted for metabolic syndrome characteristics (abdominal circumference, triglycerides, HDL-C, blood pressure, fasting glucose) and smoking.…”