Hyperthyroidism Improves the Pathological Condition of Nonalcoholic Steatohepatitis: A Case of Nonalcoholic Steatohepatitis with Graves' Disease

Yang

et al. 2020

Preprint

Background: Although thyroid function has been demonstrated to be associated with non-alcoholic fatty liver disease (NAFLD) in different population, the prevalence and features of NAFLD in hyperthyroidism have not been reported. The present study aims to investigate the prevalence of NAFLD and association of thyroid function and NAFLD in hyperthyroidism patients.Methods: This cross-sectional study was performed in Zhongshan Hospital, Fudan University, China. A total 117 patients with hyperthyroidism were consecutively recruited from 2014-2015. Thyroid function and other clinical features were measured, liver fat content was measured by color Doppler ultrasonically, NFALD was defined in patients with liver fat content more than 9.15% . Statistical analyses were performed with SPSS software package version 13.0.Results: The prevalence of NAFLD was 11.97% in hyperthyroidism. Patient with NAFLD had lower fT3 and fT4 levels than patients without NAFLD (P < 0.05). After adjusting for age, gender, metabolic parameters and inflammation factors, higher fT3 were associated with lower liver fat content (β=－0.072, P=0.009) and decreased odds ratio of NAFLD (OR=0.267, 95%CI 0.087-0.817, P=0.021). Conclusions: The prevalence of NAFLD was 11.97% in hyperthyroidism patients, and FT3 level was negatively associated with the liver fat content in this population.

Section: Discussionsupporting

confidence: 90%

Thyroid function and non-alcoholic fatty liver disease in hyperthyroidism patients

Yang

et al. 2020

Preprint

“…In the attempt to clarify the mechanisms underlying the anti-steatotic capacity of T3, some studies on T3-regulated cellular pathways that lead to the generation of free fatty acids from stored lipid droplets in the liver, suggested that TH stimulation of fatty acid β-oxidation is also coupled with induction of hepatic autophagy to deliver fatty acids to mitochondria ( 15 ). With regard to human data, a recent report, presenting an example of a patient with NASH complicated by Graves' disease, indicated that hyperthyroidism may improve the pathological condition of NASH ( 16 ). Besides obesity, NAFLD is also associated with another manifestation of the metabolic syndrome, the insulin resistance ( 17 ).…”

Section: Thyroid Hormone T3 and Liver Diseasementioning

confidence: 99%

Thyroid Hormones, Thyromimetics and Their Metabolites in the Treatment of Liver Disease

2018

The signaling pathways activated by thyroid hormone receptors (THR) are of fundamental importance for organogenesis, growth and differentiation, and significantly influence energy metabolism, lipid utilization and glucose homeostasis. Pharmacological control of these pathways would likely impact the treatment of several human diseases characterized by altered metabolism, growth or differentiation. Not surprisingly, biomedical research has been trying for the past decades to pharmacologically target the 3,5,3′-triiodothyronine (T3)/THR axis. In vitro and in vivo studies have provided evidence of the potential utility of the activation of the T3-dependent pathways in metabolic syndrome, non-alcoholic fatty liver disease (NAFLD), and in the treatment of hepatocellular carcinoma (HCC). Unfortunately, supra-physiological doses of the THR agonist T3 cause severe thyrotoxicosis thus hampering its therapeutic use. However, the observation that most of the desired beneficial effects of T3 are mediated by the activation of the beta isoform of THR (THRβ) in metabolically active organs has led to the synthesis of a number of THRβ-selective thyromimetics. Among these drugs, GC-1, GC-24, KB141, KB2115, and MB07344 displayed a promising therapeutic strategy for liver diseases. However, although these drugs exhibited encouraging results when tested in the treatment of experimentally-induced obesity, dyslipidemia, and HCC, significant adverse effects limited their use in clinical trials. More recently, evidence has been provided that some metabolites of thyroid hormones (TH), mono and diiodothyronines, could also play a role in the treatment of liver disease. These molecules, for a long time considered inactive byproducts of the metabolism of thyroid hormones, have now been proposed to be able to modulate and control lipid and cell energy metabolism. In this review, we will summarize the current knowledge regarding T3, its metabolites and analogs with reference to their possible clinical application in the treatment of liver disease. In particular, we will focus our attention on NAFLD, non-alcoholic steatohepatitis (NASH) and HCC. In addition, the possible therapeutic use of mono- and diiodothyronines in metabolic and/or neoplastic liver disease will be discussed.

“…Adjusting for age or BMI, they found a low TT4 concentration was an independent risk factor for hepatic steatosis in this population-based study (p = 0.0143; p <0.0001). Recently, Miyake et al [10] published a case of NASH with Graves' Disease. They treated the patient with thyroid hormone and considered that hyperthyroidism may be a new way to improve the pathological condition of NASH.…”

Section: The Association Between Sarcopenia and Non-alcoholic Fatty Lmentioning

confidence: 99%

The association between sarcopenia and non-alcoholic fatty liver disease

Chen

2017

Journal of Hepatology