The association of non-alcoholic fatty liver disease with thyroid peroxidase and thyroglobulin antibody: A new insight from SPECT-China study

Abstract

Non-alcoholic fatty liver disease (NAFLD) has been studied with inflammation and immune, but the link with thyroid autoimmunity is unreported. This study aimed to explore the direct association of NAFLD with thyroid autoimmune disease (AITD) among participants with normal thyroid stimulating hormone (TSH) levels. The data were obtained from a cross-sectional study (SPECT-China). A total of 7982 participants were enrolled. Participants underwent several checkups including peroxidase antibody (TPOAb), thyroglobulin antibody (TgAb), thyroid, and liver ultrasonography (US). The prevalence of NAFLD was higher in TPOAb and/or TgAb positive [TPO/TgAb (+)] group and TPOAb and/or TgAb together with US positive [TPO/TgAb (+) and US (+)] group for both genders. After full adjustment, binary logistic analysis showed the presence of NAFLD was positively associated with the serum level of TPOAb in men (p < .001) and TgAb in women (p = .001). Both TPO/TgAb (+) and TPO/TgAb (+) and US (+) were associated with an increased risk of NAFLD in both genders [TPO/TgAb (+): odds ratio (OR) 1.474, 95% confidence interval (CI) 1.102, 1.970 in men and OR 1.308, 95%CI 1.061, 1.612 in women; TPO/TgAb (+) and US (+): OR 1.796, 95%CI 1.143, 2.820 in men and OR 1.380, 95%CI 1.058, 1.801 in women]. Thus, we got a conclusion that the prevalence of NAFLD was positively associated with the level and the positivity of TPOAb and TgAb among participants with normal TSH levels. This is the first report suggesting that there might exist common pathways in the pathogenesis of NAFLD and thyroid autoimmunity.

<p>Elevated TPOAb is a Strong Predictor of Autoimmune Development in Patients of Type 2 Diabetes Mellitus and Non-Alcoholic Fatty Liver Disease: A Case–Control Study</p>

“…As can be seen from Table 2, the prevalence of thyroid antibodies positive in the T2DM combined NAFLD group was significantly higher than that in the T2DM group alone, and TPOAb positive are more than TGAb-positive patients, the prevalence of TPOAb-positive was significantly different between the two groups. Other studies have also shown that elevated TPOAb is predominant in patients with positive thyroid autoimmunity whether in patients with T2DM alone and NAFLD alone, 9,25,29 consistent with our findings. This study found that the prevalence of thyroid autoimmunity in patients with T2DM complicated with NAFLD was 6.6%, which was not statistically significant compared with T 2 DM alone group (3.7%), but it also showed a significant upward trend.…”

“…20 However, it has also been found that there are many people with T2DM complicated with autoimmune thyroid disease, and the intrinsic mechanism may be more complex. Sarfo-Kantanka, O. and Chen, Y. et al reported the presence of serum thyroid autoantibodies in patients with T2DM and NAFLD, respectively, 9,19 but it remains unknown whether thyroid autoimmunity exists in patients with both chronic endocrine diseases and the intrinsic association. However, in recent years there have been reports on the association of thyroid autoimmunity and thyroid cancer, ischemic stroke, cognitive and emotional disorders and adverse pregnancy outcomes.…”

“…7,8 In addition, it has also been found that patients with NAFLD experience abnormalities in thyroid autoantibodies. 9 Both thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TGAb) belong to thyroid autoantibodies, and the elevation of thyroid autoantibodies is often accompanied by autoimmune thyroid diseases. 10 In autoimmune thyroid diseases, such as the vast majority of patients with Hashimoto's thyroiditis and some patients with primary hyperthyroidism, a significant increase of thyroid autoantibodies may occur, and the pathogenesis is not fully clarified, which is currently believed to be related to lymphocyte infiltration in the thyroid follicular stroma.…”

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

“…We further discovered that TgAb may be a protective factor for MAFLD in both genders. To our notice, there is only one study by Chen ( 45 ) focusing on the association between thyroid autoantibodies and NAFLD so far. In contrast, the study revealed a positively association between AITD and the prevalence of NAFLD.…”

A Cross-Sectional Study of Oral Lichen Planus Associated With Thyroid Diseases in East China

“…Thyroid disease information of the 10,441 normal people as a control group came from an epidemiological survey conducted by endocrinology department of Shanghai Ninth People's Hospital in east China from 2014 to 2015. The gender, age, TPOAb, TGAb, TSH, FT3, FT4, and B-ultrasound results of these people are all from the epidemiological investigation (16).…”