Relationship between serum TSH level with obesity and NAFLD in euthyroid subjects

Abstract

To explore the relationship between serum thyroid stimulating hormone (TSH) level and obesity and nonalcoholic fatty liver disease (NAFLD) in euthyroid subjects, 1322 subjects were subjected to a questionnaire survey and physical examination. Fasting blood samples were collected to test serum TSH, plasma glucose and lipids. Fatty liver was diagnosed by type B ultrasonography. The relationship between serum TSH level and body mass index (BMI), percentage of body fat and NAFLD was analyzed. The results showed that serum TSH level was significantly higher in females than in males at the same group, and it was significantly higher in overweight group than in control group. Levels of body weight, BMI, waist circumference and percentage of body fat were increased in TSH >2.5 group compared to TSH ≤2.5 group in women. However, plasma lipids showed no significant differences. In males all the parameters showed no significant differences between two groups. Serum TSH was significantly correlated with body weight, BMI, waist circumference and percentage of body fat after adjustment for age in females. Multiple linear regression analysis revealed that percentage of body fat and BMI contributed significantly to the variance of TSH. Serum TSH level was significantly higher in nonalcoholic fatty liver group than in normal group in females. Multiple logistic regression analysis showed that TSH level was not the independent risk factor of NAFLD. Taken together the data suggest that serum TSH in normal range is significantly correlated with BMI and percentage of body fat in females. And the change of TSH level would not influence the prevalence of NAFLD.

Nonalcoholic Fatty Liver Disease Is Not Associated with Thyroid Hormone Levels and Hypothyroidism: A Systematic Review and Meta-Analysis

“…Eleven articles were excluded (4 articles had no comparison group, 3 articles did not report a subject of interest, and 4 articles did not report an outcome of interest). Fourteen observational studies (9 cross-sectional studies [14,15,16,17,18,19,20,21,22], 4 case-control studies [23,24,25,26], and 1 cohort study [27]) involving 7,191 NAFLD patients and 30,003 controls were included in the meta-analysis. Table 1 describes the detailed characteristics and quality assessment of the included studies.…”

“…A total of 5 studies [14,15,16,20,27] involving 26,454 participants, 6 studies [14,15,16,20,23,27] involving 27,070 studies, and 9 studies [14,15,16,17,18,20,25,26,27] involving 32,347 participants were included in our meta-analyses for assessing the association between NAFLD and subclinical hypothyroidism, overt hypothyroidism, and overall hypothyroidism, respectively. NAFLD was not associated with subclinical hypothyroidism (pooled OR = 0.63, 95% CI: 0.18-2.20, p = 0.47, I 2 = 97%, p heterogeneity <0.01), overt hypothyroidism (pooled OR = 1.37, 95% CI: 0.78-2.41, p = 0.27, I 2 = 81%, p heterogeneity = 0.08), or overall hypothyroidism (pooled OR = 1.21, 95% CI: 0.91-1.61, p = 0.18, I 2 = 72%, p heterogeneity = 0.02) compared with non-NAFLD controls (Fig.…”

“…However, there have also been a few large trials that found no association. Zhang et al [26] conducted a population-based study involving more than 1,300 Chinese subjects and showed that TSH is not an independent risk factor for NAFLD. Lee et al [27] conducted a study involving almost 20,000 healthy Korean subjects and found no association between NAFLD and hypothyroidism in all subtypes (overt and subclinical hypothyroidism).…”

Thyroid function is associated with non‐alcoholic fatty liver disease in chronic hepatitis B‐infected subjects

“…A large study conducted by the Cleveland Clinic (USA) indicated higher rates of hypothyroidism in NAFLD subjects, compared with the non‐NAFLD group (21.1% vs 9.5%, respectively) . In China, the association between thyroid hormones and NAFLD were studied in euthyroid individuals . Xu et al .…”

Molecular Functions of Thyroid Hormones and Their Clinical Significance in Liver-Related Diseases

“…Thyroid function tests additionally confirmed the existence of several thyroid functional abnormalities in patients with chronic liver disease. However, in euthyroid patients, TSH level was not an independent risk factor, and changes in TSH levels did not influence the prevalence of NAFLD [8, 9, 101]. …”