Thyroid Function and the Risk of Nonalcoholic Fatty Liver Disease: The Rotterdam Study

Bano, Arjola; Chaker, Layal; Plompen, Elisabeth P.C.; Hofman, Albert; Dehghan, Abbas; Franco, Oscar H.; Janssen, Harry L A; Murad, Sarwa Darwish; Peeters, Robin P.

doi:10.1210/jc.2016-1300

Cited by 170 publications

(176 citation statements)

References 41 publications

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“…Recently, a publication from the Rotterdam group has also found a positive association between the prevalence of NAFLD and TSH levels [26]. The group was able to demonstrate that the risk of NAFLD progressively decreased from a hypothyroid to a hyperthyroid state [26]. However, in both studies, there was no analysis within the normal reference range.…”

Section: Discussionmentioning

confidence: 98%

“…In 2012, a Korean study showed that NAFLD was statistically significantly associated with hypothyroidism and subclinical hypothyroidism in a dose-dependent manner, independently of metabolic syndrome risk factors [27]. Recently, a publication from the Rotterdam group has also found a positive association between the prevalence of NAFLD and TSH levels [26]. The group was able to demonstrate that the risk of NAFLD progressively decreased from a hypothyroid to a hyperthyroid state [26].…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Most of them showed that hypothyroidism, in its overt or subclinical type, is independently associated to NAFLD [26,27], suggesting that hypothyroidism may directly result in NAFLD irrespective of other common metabolic risk factors. In a recent prospective study, lower thyroxine (T4) levels were associated with a higher risk for NAFLD [26]. Nevertheless, though this association has been demonstrated for subclinical hypothyroidism, the thyroid function is a continuum and the association between thyroid-stimulating hormone (TSH) levels within the normal range and NAFLD has not been well established.…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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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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“…These results indicated that there was a need for better understanding of the crosstalk effects between NAFLD, hyperuricemia, and HTN in diabetes. Two very recent studies reported [39, 40] that the higher free thyroxine levels were associated with a decreased risk of NAFLD. In our study, the higher T3 levels were related to an increased risk of HTN in type 2 diabetes.…”

Section: Discussionmentioning

confidence: 99%

Nonalcoholic Fatty Liver Disease and Associated Metabolic Risks of Hypertension in Type 2 Diabetes: A Cross-Sectional Community-Based Study

Ding

Xü

Wang

et al. 2017

International Journal of Endocrinology

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The mechanisms facilitating hypertension in diabetes still remain to be elucidated. Nonalcoholic fatty liver disease (NAFLD), which is a higher risk factor for insulin resistance, shares many predisposing factors with diabetes. However, little work has been performed on the pathogenesis of hypertension in type 2 diabetes (T2DM) with NAFLD. The aim of this study is to investigate the prevalence of hypertension in different glycemic statuses and to analyze relationships between NAFLD, metabolic risks, and hypertension within a large community-based population after informed written consent. A total of 9473 subjects aged over 45 years, including 1648 patients with T2DM, were enrolled in this cross-sectional study. Clinical and biochemical parameters of all participants were determined. The results suggested that the patients with prediabetes or T2DM were with higher risks to have hypertension. T2DM with NAFLD had significantly higher levels of blood pressure, triglyceride, uric acid, and HOMA-IR than those without NAFLD. Data analyses suggested that hypertriglyceridemia [OR = 1.773 (1.396, 2.251)], NAFLD [OR = 2.344 (1.736, 3.165)], hyperuricemia [OR = 1.474 (1.079, 2.012)], and insulin resistance [OR = 1.948 (1.540, 2.465)] were associated with the higher prevalence of hypertension independent of other metabolic risk factors in type 2 diabetes. Further studies are needed to focus on these associations.

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Association of Thyroid Function With Life Expectancy With and Without Cardiovascular Disease

et al. 2017

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IMPORTANCEVariations in thyroid function within reference ranges are associated with an increased risk of cardiovascular disease (CVD) and mortality. However, the impact of thyroid function on life expectancy (LE) and the number of years lived with and without CVD remains unknown.OBJECTIVE To investigate the association of thyroid function with total LE and LE with and without CVD among euthyroid individuals. DESIGN, SETTING, AND PARTICIPANTSThe Rotterdam Study, a population-based, prospective cohort study. We included participants without known thyroid disease and with thyrotropin and free thyroxine (FT 4 ) levels within the reference ranges. MAIN OUTCOMES AND MEASURESMultistate life tables were used to calculate total LE and LE with and without CVD among thyrotropin and FT 4 tertiles. Life expectancy estimates in men and women aged 50 years and older were obtained using prevalence, incidence rates, and hazard ratios for 3 transitions (healthy to CVD, healthy to death, and CVD to death), adjusting for sociodemographic and cardiovascular risk factors. RESULTSThe mean (SD) age of the 7785 participants was 64.7 (9.8) years, and 52.5% were women. Over a median follow-up of 8.1 (interquartile range, 2.7-9.9) years, we observed 789 incident CVD events and 1357 deaths. Compared with those in the lowest tertile, men and women in the highest thyrotropin tertile lived 2.0 (95% CI, 1.0 to 2.8) and 1.4 (95% CI, 0.2 to 2.4) years longer, respectively, of which, 1.5 (95% CI, 0.2 to 2.6) and 0.9 (95% CI, −0.2 to 2.0) years longer without CVD. Compared with those in the lowest tertile, the difference in life expectancy for men and women in the highest FT 4 tertile was −3.2 (95% CI, −5.0 to −1.4) and −3.5 (95% CI, −5.6 to −1.5) years, respectively, of which, −3.1 (95% CI, −4.9 to −1.4) and −2.5 (95% CI, −4.4 to −0.7) years without CVD.CONCLUSIONS AND RELEVANCE At the age of 50 years, participants with low-normal thyroid function live up to 3.5 years longer overall and up to 3.1 years longer without CVD than participants with high-normal thyroid function. These findings provide supporting evidence for a reevaluation of the current reference ranges of thyroid function and can help inform preventive and clinical care.

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Thyroid Function and the Risk of Nonalcoholic Fatty Liver Disease: The Rotterdam Study

Abstract: Lower thyroid function is associated with an increased NAFLD risk. These findings may lead to new avenues regarding NAFLD prevention and treatment.

Cited by 170 publications

References 41 publications

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

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

Nonalcoholic Fatty Liver Disease and Associated Metabolic Risks of Hypertension in Type 2 Diabetes: A Cross-Sectional Community-Based Study

Association of Thyroid Function With Life Expectancy With and Without Cardiovascular Disease

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