Hypothyroidism in a patient with non-alcoholic fatty liver disease

Gardner, Clarissa; Richardson, Paul; Wong, Christopher; Polavarapu, Naveen; Kemp, Graham J.; Cuthbertson, Daniel J.

doi:10.1136/bmj.c7199

Cited by 16 publications

(10 citation statements)

References 19 publications

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“…Following levothyroxine replacement in a patient with hypothyroidism and NAFLD, normalisation of LFTs has been reported with a much improved lipid profile and a drastic reduction in liver fat as measured by magnetic resonance spectroscopy [31]. Hepatic histological changes in NAFLD can mimic those of hypothyroidism [31], and as such hypothyroidism should be considered in the differential diagnosis of NAFLD with or without an associated metabolic syndrome picture. An association of hypothyroidism with primary biliary cirrhosis is also well established (see Section 6.3).…”

Section: Hepatic Metabolismmentioning

confidence: 96%

“…Hypothyroidism is also twice as common in nonalcoholic fatty liver disease (NAFLD) compared to other causes of chronic liver disease (15% versus 7%, respectively) [30]. Following levothyroxine replacement in a patient with hypothyroidism and NAFLD, normalisation of LFTs has been reported with a much improved lipid profile and a drastic reduction in liver fat as measured by magnetic resonance spectroscopy [31]. Hepatic histological changes in NAFLD can mimic those of hypothyroidism [31], and as such hypothyroidism should be considered in the differential diagnosis of NAFLD with or without an associated metabolic syndrome picture.…”

Section: Hepatic Metabolismmentioning

confidence: 98%

See 1 more Smart Citation

Thyroid disorders and gastrointestinal and liver dysfunction: A state of the art review

Kyriacou

McLaughlin

Syed

2015

European Journal of Internal Medicine

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Section: Hepatic Metabolismmentioning

confidence: 96%

Section: Hepatic Metabolismmentioning

confidence: 98%

Thyroid disorders and gastrointestinal and liver dysfunction: A state of the art review

Kyriacou

McLaughlin

Syed

2015

European Journal of Internal Medicine

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“…In statistical terms this may be due to the lack of a significant change in IHCL in the majority of patients who had normal IHCL, but this masks reductions in steatosis in those individuals with elevated IHCL. Given the responsiveness of liver fat to hormone replacement demonstrated by our group after 6 weeks of treatment (42), it would be anticipated that 6 months would be an appropriate length of time for some changes to be seen. It would thus appear that there is a differential regulation of the different fat depots (visceral, subcutaneous and liver fat depots) by the GH/IGF1 axis with more critical involvement in the regulation of VAT and SAT mass compared with liver fat, which may primarily be regulated by other physiological mechanisms.…”

Section: Discussionmentioning

confidence: 99%

Hepatic steatosis, GH deficiency and the effects of GH replacement: a Liverpool magnetic resonance spectroscopy study

Gardner

Irwin

Daousi

et al. 2012

European Journal of Endocrinology

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Objective: Non-alcoholic fatty liver disease (NAFLD) is reported to be more common in patients with GH deficiency (GHD) than in the general population. We aimed to determine: i) liver fat in patients with GHD compared with age and body mass index (BMI)-matched controls; and ii) effect of 6 months of GH replacement (GHR) on liver fat. Participants and methods: The study included 28 GHD patients and 24 controls. 12 patients were studied before and after 6 months of GHR. Anthropometry, liver enzymes and lipid profiles were measured, and body composition and intrahepatocellular lipid (IHCL) were determined by magnetic resonance imaging and spectroscopy. Results: Age and BMI (median (inter-quartile range)) of patients and controls were 52.6 (14) vs 52.6 (12) years (PZ0.9) and 27.8 (24.7, 34.7) vs 27.9 (25.1, 32.1) kg/m 2 (PZ0.9). IGF1 was lower in the patients (11.5 vs 16.0 nmol/l, PZ0.002). There was no difference in liver transaminases, lipids or IHCL between patients and controls (2.8 (1.3, 8.6) vs 5.0 (1.5, 12.7), PZ0.72), despite significantly higher visceral fat in GHD patients. Thirty-two percent of patients and 50% of controls had NAFLD (defined as IHCL O5.6%), and the relationship between IHCL and BMI was the same in each group. GHR significantly reduced abdominal subcutaneous and visceral fat in all patients; however, GHR did not reduce liver fat. Conclusions: NAFLD is equally common in patients with GHD and matched controls. GHR is associated with a hierarchical reduction in fat deposition (fat loss: visceral O subcutaneous O liver). Further studies involving GHD patients with NAFLD are required to conclude the role of GHR in treating NAFLD.

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“…Pharmacological correction of hypothyroidism is metabolically beneficial, and in a single case report, correction of profound hypothyroidism improved lipid profile and hepatic steatosis, as measured by magnetic resonance spectroscopy (MRS) (92). Administration of thyroid hormones to euthyroid patients is detrimental; however, targeted manipulation of thyroid hormone action could have potential benefits.…”

Section: Thyroidmentioning

confidence: 99%

Mechanisms in endocrinology: Non-alcoholic fatty liver disease in common endocrine disorders

Hazlehurst

Tomlinson

2013

European Journal of Endocrinology

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Non-alcoholic fatty liver disease (NAFLD) is a spectrum of disease spanning from simple benign steatosis to steatohepatitis with fibrosis and scarring that can eventually lead to cirrhosis. Its prevalence is rising rapidly and is developing into the leading indication for liver transplantation worldwide. Abnormalities in endocrine axes have been associated with NALFD, including hypogonadism, hypothyroidism, GH deficiency and hypercortisolaemia. In some instances, correction of the endocrine defects has been shown to have a beneficial impact. While in patients with type 2 diabetes the association with NAFLD is well established and recognised, there is a more limited appreciation of the condition among common endocrine diseases presenting with hormonal excess or deficiency. In this review, we examine the published data that have suggested a mechanistic link between endocrine abnormalities and NAFLD and summarise the clinical data endorsing these observations.

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Hypothyroidism in a patient with non-alcoholic fatty liver disease

Abstract: Consider hypothyroidism as a cause of non-alcoholic fatty liver disease

Cited by 16 publications

References 19 publications

Thyroid disorders and gastrointestinal and liver dysfunction: A state of the art review

Thyroid disorders and gastrointestinal and liver dysfunction: A state of the art review

Hepatic steatosis, GH deficiency and the effects of GH replacement: a Liverpool magnetic resonance spectroscopy study

Mechanisms in endocrinology: Non-alcoholic fatty liver disease in common endocrine disorders

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