Impact of hypothyroidism on the development of non-alcoholic fatty liver disease: A 4-year retrospective cohort study

Lee, Kil Woo; Bang, Ki Bae; Rhee, Eun-Jung; Kwon, Hee Jin; Lee, Mi Yeon; Cho, Yong Kyun

doi:10.3350/cmh.2015.21.4.372

Cited by 59 publications

(60 citation statements)

References 23 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 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.…”

Section: Resultsmentioning

confidence: 99%

“…For subclinical hypothyroidism, removal of Lee et al [27] moved the overall effect to favor NAFLD with an OR of 1.31 (95% CI: 1.12-1.53), suggesting that Lee et al was partly the reason for the high between-study heterogeneity. For overt hypothyroidism, removal of Lee et al moved the overall effect to favor NAFLD with an OR of 1.76 (1.28-2.41), suggesting that Lee et al also could contribute to the presence of heterogeneity.…”

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%

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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“…However, NAFLD patients were more likely to have low TSH levels although hypothyroidism and hyperthyroidism were not associated with NAFLD. The observed changes in TSH and free T3 levels may attribute to alterations in thyroid hormones due to sick euthyroid syndrome in NAFLD (28,43).…”

Section: Discussionmentioning

confidence: 95%

Association and impact of non-alcoholic fatty liver disease on thyroid function

2017

Int. J. Curr. Res. Med. Sci.

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Nonalcoholic fatty liver disease (NAFLD) means accumulation of fat mainly triglyceride exceeding 5 % of liver weight, affecting approximately 20% of population in developed countries. Thyroid dysfunction have been frequently associated with non-alcoholic fatty liver disease. The aim of this study is to determine any association between nonalcoholic fatty liver disease and thyroid dysfunction and to evaluate the impact of non-alcoholic fatty liver disease on thyroid function tests. Subjects and methods: This study was carried out on sixty adult men and women with nonalcoholic fatty liver disease and sixty age-and sex-matched males and females without the disease. NAFLD patients were subjected to a full assessment of medical history, physical examination, abdominal ultrasonography as well as routine laboratory tests. Patients and controls underwent liver function and thyroid function testing including thyroid antibodies. Results: Thirteen patients with NAFLD (21.7%) were found to have thyroid dysfunction. The most common thyroid dysfunction was subclinical hypothyroidism which was found in 10 (16.7%) NAFLD patients followed by overt hypothyroidism in 3 patients (5%). There were statistically significant difference between patients and controls as regard to TSH (p=0.0001), FT4 (p=0.005), FT3 (P=0.043), anti-TPO (p=0.047), anti-TG (p=0.001), IR (p=0.024), insulin (p=0.002), and Leptin (p=0.002). TSH concentration was significantly correlated with ALT (r= 0.381), GGT (r=0.354), HbA1C (r=0.288), triglyceride (r=0.368), FT4 (r=0.414), FT3(r=0.231), anti-TPO(r=0.298), serum insulin (r= 0.287), insulin resistance (IR) (r= 0.453), and serum Leptin (r=0.360) levels.In our patients, hepatic steatosis in the form of increased liver echogenecity was present in almost all patients (100%), and hepatomegaly in twenty-four patients (40%). Thus. Hepatic steatosis were correlated significantly with ALT, GGT, HbA1C, triglyceride, HDL-C, TSH, FT4, FT3, anti-TPO, anti-TG, serum insulin, insulin resistance (IR), and serum Leptin. Conclusion: Thyroid dysfunctions are common in NAFLD patients, with subclinical hypothyroidism hypothyroidism being the most prevalent one. Hepatic steatosis has shown an evident positive correlation with elevated TSH as well as thyroid autoantibodies.

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“…This attribute was explained as a linkage mechanism between SH and metabolic syndrome. 13 The underlying mechanism for this observation has been proposed that the thyroid hormones stimulate the expression of uncoupling proteins in the mitochondria of fat and skeletal muscle through modulate adrenergic receptors by enhancing responsiveness of catecholamines.…”

Section: Discussionmentioning

confidence: 99%

Comparative study of lipid profile between clinical and subclinical hypothyroidism

2018

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INTRODUCTIONIndia as a developing nation is currently facing the burden of not only infectious diseases, but also of noncommunicable and other metabolic diseases. Diseases like cardiovascular diseases, diabetes mellitus and hypertension are more prevalent and results in an increased morbidity and mortality. However, certain endocrine disorders, especially disorders of thyroid metabolism are also on the rise. Hypothyroidism is a broad clinical spectrum of disorder ranging from overt hypothyroidism or myxedema to subclinical disorders with abnormal or mild subclinical disease.In India, hypothyroidism has been recognized as a public health problem for the past several decades and has been termed as Iodine Deficiency Disorders (IDD). A universal salt iodization programme was adopted in 1983 ABSTRACT Background: Subclinical hypothyroidism (SH) is characterized by elevated levels of serum thyroid stimulating hormone in the presence of normal thyroxin levels. Subclinical hypothyroidism is often associated with elevated total cholesterol and other lipid profile parameters. This study was done to evaluate the lipid metabolism in subclinical hypothyroidism. Methods: This case control study was done to compare the lipid profile parameters between subclinical and overt hypothyroidism cases attending the outpatient facility of our tertiary care hospital of our medical college in Puducherry. Newly diagnosed cases of hypothyroidism were selected by convenient sampling. A total of 37 SH cases and 31 overt hypothyroidism cases were included. Blood samples were drawn to measure lipid profile. A 2D echocardiogram was done to evaluate cardiac function. Ultrasonogram was done to evaluate fatty liver. Results: The mean age of the participants in the subclinical hypothyroidism group was 34.2±12.2 years while in the clinical hypothyroidism group was 35.7±9.8 years. About 13.5% of the participants in subclinical hypothyroidism group and 12.9% of the participants in clinical hypothyroidism had fatty liver in ultrasound. A significant difference was observed in the mean values of total cholesterol, triglycerides and LDL levels between clinical and subclinical hypothyroidism. Conclusions: This study highlights the need for screening of subclinical hypothyroidism in order to prevent the incidences of cardiovascular complications and other diseases like metabolic syndrome.

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Impact of hypothyroidism on the development of non-alcoholic fatty liver disease: A 4-year retrospective cohort study

Cited by 59 publications

References 23 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

Association and impact of non-alcoholic fatty liver disease on thyroid function

Comparative study of lipid profile between clinical and subclinical hypothyroidism

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