JGH Open (Jun 2020)

Thyroid‐stimulating hormone is an independent risk factor of non‐alcoholic fatty liver disease

  • Kazuki Tahara,
  • Takemi Akahane,
  • Tadashi Namisaki,
  • Kei Moriya,
  • Hideto Kawaratani,
  • Kosuke Kaji,
  • Hiroaki Takaya,
  • Yasuhiko Sawada,
  • Naotaka Shimozato,
  • Shinya Sato,
  • Soichiro Saikawa,
  • Keisuke Nakanishi,
  • Takuya Kubo,
  • Yukihisa Fujinaga,
  • Masanori Furukawa,
  • Koh Kitagawa,
  • Takahiro Ozutsumi,
  • Yuuki Tsuji,
  • Daisuke Kaya,
  • Hiroyuki Ogawa,
  • Hirotetsu Takagi,
  • Koji Ishida,
  • Akira Mitoro,
  • Hitoshi Yoshiji

DOI
https://doi.org/10.1002/jgh3.12264
Journal volume & issue
Vol. 4, no. 3
pp. 400 – 404

Abstract

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Background and Aim Hypothyroidism might play a crucial role in the pathogenesis of non‐alcoholic fatty liver disease (NAFLD). The association of subclinical hypothyroidism with NAFLD has been inconsistent. The relationship of NAFLD with thyroid function parameters and subclinical hypothyroidism was determined. Methods This cross‐sectional study included 70 patients with subclinical hypothyroidism and 70 controls with euthyroidism matched according to gender, age, and body mass index (BMI). NAFLD was diagnosed via abdominal ultrasonography. The association between NAFLD and subclinical hypothyroidism was analyzed. Results The prevalence of NAFLD was significantly higher in patients with subclinical hypothyroidism than in those with euthyroidism. Multivariate analysis showed that subclinical hypothyroidism was an independent risk factor of NAFLD adjusted by metabolic‐related factors, such as BMI, triglyceride, high‐density lipoprotein‐cholesterol, hypertension, and diabetes. Thyroid‐stimulating hormone (TSH) was an independent risk factor of NAFLD adjusted by the same metabolic‐related factors, but free thyroxine (FT4) was not a risk factor. The FIB‐4 index, a noninvasive marker of liver fibrosis was significantly higher in patients with subclinical hypothyroidism than in those with euthyroidism. Compared with patients with euthyroidism, the proportion of the FIB‐4 index ≥2.67 was significantly higher, and the proportion of the FIB‐4 index <1.30 was lower in patients with subclinical hypothyroidism. Conclusions TSH elevation even within the euthyroid range is an independent risk factor of NAFLD and may influence the progression of liver fibrosis, even with a normal FT4 level.

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