NAFLD in Some Common Endocrine Diseases: Prevalence, Pathophysiology, and Principles of Diagnosis and Management

Abstract

Secondary nonalcoholic fatty liver disease (NAFLD) defines those complex pathophysiological and clinical consequences that ensue when the liver becomes an ectopic site of lipid storage owing to reasons other than its mutual association with the metabolic syndrome. Disorders affecting gonadal hormones, thyroid hormones, or growth hormones (GH) may cause secondary forms of NAFLD, which exhibit specific pathophysiologic features and, in theory, the possibility to receive an effective treatment. Here, we critically discuss epidemiological and pathophysiological features, as well as principles of diagnosis and management of some common endocrine diseases, such as polycystic ovary syndrome (PCOS), hypothyroidism, hypogonadism, and GH deficiency. Collectively, these forms of NAFLD secondary to specific endocrine derangements may be envisaged as a naturally occurring disease model of NAFLD in humans. Improved understanding of such endocrine secondary forms of NAFLD promises to disclose novel clinical associations and innovative therapeutic approaches, which may potentially be applied also to selected cases of primary NAFLD.

Non-alcoholic fatty liver disease (NAFLD) as a neglected metabolic companion of psychiatric disorders: common pathways and future approaches

“…Thyroid alterations, known to be involved in the regulation of metabolism and inflammation, have been linked to psychiatric disorders [81,82], and also play an important role in the accumulation of lipid in the liver, potentially driving to NAFLD independently [83,84].…”

Thyroid Function and the Risk of Non-Alcoholic Fatty Liver Disease in Morbid Obesity

“…Even though the pathophysiology of NAFLD has been extensively studied, there is still a lot to uncover. Thyroid dysfunction, explicitly hypothyroidism, has been proposed as a possible contributory mechanism (4,5). Indeed, it is biologically plausible for this endocrine axis to play an important role in NAFLD's pathophysiology, as thyroid hormones (TH) are crucial in the regulation of several metabolic features such as lipid metabolism, body weight and insulin resistance (4,6).…”

Combined and sequential non-invasive approach to diagnosing non-alcoholic steatohepatitis in patients with non-alcoholic fatty liver disease and persistently normal alanine aminotransferase levels

“…Increased platelet volume may occur with inflammatory states,33 and alterations in serum zinc34 and thyroxine levels35 have been noted to be associated with NAFLD. Zinc is mostly found in skeletal muscle rather than the liver, and fluctuation of serum zinc levels may occur with sarcopenia,36 which has been noted with NAFLD 37.…”