Thyroid function is associated with non-alcoholic fatty liver disease in euthyroid subjects

Yang, Tao; Gu, Hongbing; Wu, Jing; Sui, Jian

doi:10.3109/07435800.2014.952014

Cited by 46 publications

(50 citation statements)

References 29 publications

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“…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.…”

Section: Resultsmentioning

confidence: 99%

“…A total of 6 studies [15,16,17,19,21,22] involving 6,294 participants, 7 studies [15,16,17,19,21,22,27] involving 24,838 studies, and 9 studies [15,16,17,19,20,21,22,24,27] involving 26,147 participants were included in our meta-analyses for assessing the association between NAFLD and FT 3 , FT 4 , and TSH, respectively. Patients who had NAFLD did not show a significant difference concerning FT 3 (pooled MD = 0.04, 95% CI: -0.11 to 0.19, p = 0.61, I 2 = 96%, p heterogeneity <0.01), FT 4 (pooled MD = -0.27, 95% CI: -0.70 to 0.16, p = 0.22, I 2 = 98%, p heterogeneity <0.01), and TSH (pooled MD = 0.11, 95% CI: -0.03 to 0.24, p = 0.12, I 2 = 88%, p heterogeneity = 0.03) compared with non-NAFLD controls (Fig.…”

Section: Resultsmentioning

confidence: 99%

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

2017

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Background: Whether hypothyroidism is related to nonalcoholic fatty liver disease (NAFLD) is unclear. Thyroid dysfunction is closely related with components of metabolic syndrome. Given the hepatic manifestation of metabolic syndrome, several studies have investigated the association between NAFLD and thyroid dysfunction and have demonstrated inconsistent results. Thus, we conducted a systematic review and meta-analysis to better characterize the association between NAFLD and thyroid dysfunction. Methods: MEDLINE and Embase were searched through July 2016. The primary outcome was the association between NAFLD and subclinical, overt, and overall hypothyroidism. The secondary outcome was the difference in thyroid hormone levels (free triiodothyronine [FT₃], free thyroxine [FT₄], or thyroid-stimulating hormone [TSH]) between NAFLD patients and non-NAFLD controls. Pooled odds ratios (OR) and 95% CI were calculated using a random-effects model. All continuous data are summarized as the mean difference along with 95% CI. Results: Data were extracted from 14 studies involving 7,191 NAFLD patients and 30,003 controls. NAFLD was not associated with subclinical, overt, or overall hypothyroidism compared with non-NAFLD controls. Patients who had NAFLD did not show a significant difference in FT₃, FT₄, or TSH compared with non-NAFLD controls. Conclusions: Our meta-analysis demonstrates no significant association between NAFLD and subclinical, overt, or overall hypothyroidism, and we also found no significant difference in thyroid hormone levels between participants with and without NAFLD.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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

2017

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“…Most of the studies documented a positive association of hypothyroidism with NAFLD . However, the conclusions from the studies regarding the association of free triiodothyronine (FT3), the bioactive form of thyroid hormones, with NAFLD in euthyroid subjects remained inconsistent . Previous studies in Chinese and Dutch people showed that high‐normal FT3 levels were associated with the risk of NAFLD, but other studies did not find the same association .…”

Section: Introductionmentioning

confidence: 99%

“…However, the conclusions from the studies regarding the association of free triiodothyronine (FT3), the bioactive form of thyroid hormones, with NAFLD in euthyroid subjects remained inconsistent . Previous studies in Chinese and Dutch people showed that high‐normal FT3 levels were associated with the risk of NAFLD, but other studies did not find the same association . In addition, most of the studies showed that lower free thyroxine (FT4) and higher TSH levels within the normal range were associated with the risk of NAFLD in euthyroid adults.…”

Section: Introductionmentioning

confidence: 99%

Free triiodothyronine is associated with the occurrence and remission of nonalcoholic fatty liver disease in euthyroid women

Chen

Hou

et al. 2019

Eur J Clin Investigation

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Background The association between nonalcoholic fatty liver disease (NAFLD) and free triiodothyronine (FT3) in euthyroid subjects was in dispute. We aimed to investigate this issue in a population‐based cohort study. Materials and methods A total of 3144 euthyroid subjects at baseline from the Shanghai Nicheng Atherosclerosis Study were selected for the cross‐sectional analysis, and 2089 subjects being followed up after 2.2 years were selected for the longitudinal analysis. NAFLD was diagnosed by ultrasound. The cut‐off point of elevated alanine aminotransferase (ALT) level was 40 U/L. The FIB‐4 index was used to assess the risk of advanced liver fibrosis. Results Age‐adjusted mean levels of FT3 and FT3/free thyroxine (FT4) ratio were higher in subjects with NAFLD than those without NAFLD and linearly increased with a higher risk of NAFLD progression (assessed by levels of ALT and FIB‐4 index) in euthyroid women but not in men. After adjustment for confounding variables, FT3 levels significantly increased with the presence of NAFLD (β = 0.1, P < 0.001) and linearly increased with a higher risk of NAFLD progression in euthyroid women. After a 2.2‐year follow‐up, FT3 levels increased with the occurrence of NAFLD (mean change percentage: 1.4%) and decreased with the remission of NAFLD (mean change percentage: −2.7%) in euthyroid women. Conclusions There are positive associations of FT3 levels with NAFLD and the risk of NAFLD progression in euthyroid women. The changes in FT3 levels with the alteration of NAFLD status may be an adaptive response to maintain energy and metabolic homeostasis.

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“…In 2014, a Chinese group analyzed the prevalence of NAFLD in euthyroid subjects and found a positive association between TSH levels, even within the reference range, and NAFLD, independent of known metabolic risk factors, evaluated through multiple logistic regression [33]. However, this study evaluated less than 1,000 subjects.…”

Section: Discussionmentioning

confidence: 99%

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

Janovsky¹,

Cesena

Valente

et al. 2018

Eur Thyroid J

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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.

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Thyroid function is associated with non-alcoholic fatty liver disease in euthyroid subjects

Abstract: Our findings suggest that serum FT4 and TSH levels, even those within the reference range, are associated with NAFLD in the general population, independent of known metabolic risk factors.

Cited by 46 publications

References 29 publications

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

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

Free triiodothyronine is associated with the occurrence and remission of nonalcoholic fatty liver disease in euthyroid women

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

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