Abstract
Non-alcoholic fatty liver disease (NAFLD) is a prevalent liver disease encompassing a broad spectrum of pathologic changes in the liver. Metabolic derangements are suggested to be main causes of NAFLD. As thyroid hormone is a main regulator of energy metabolism, there may be a link between NAFLD and thyroid function. In previous studies, the association between NAFLD and thyroid function was not conclusive. The aim of this study was to clarify the relationship between NAFLD and thyroid function, focusing on subclinical hypothyroidism, using nationwide survey data representing the Korean population. NAFLD was defined as a hepatic steatosis index of 36 or higher. Based on the analysis of nationwide representative data, subclinical hypothyroidism was related to a high risk of NAFLD in males, but not in females. Our study showed that thyroid function might play a substantial role in the development of NAFLD, especially in males. Further study to elucidate the underlying mechanism of gender specific association of mild thyroid dysfunction and NAFLD would be required.
Highlights
As hypertension, dyslipidaemia, diabetes mellitus (DM), and central obesity are well established risk factors for Non-alcoholic fatty liver disease (NAFLD), insulin resistance is suggested to be closely related to the development of NAFLD11,12
Increased insulin resistance and dyslipidaemia are observed in hypothyroidism, even in subclinical hypothyroidism, and several studies have shown that subclinical hypothyroidism is related to an increased risk of metabolic syndrome[16,17,18,19]
Prevalence of NAFLD by HSI (≥36) was 33.3% in the euthyroid group and 41.5% in the subclinical hypothyroidism group, with no significant difference found between the two groups
Summary
Dyslipidaemia, diabetes mellitus (DM), and central obesity are well established risk factors for NAFLD, insulin resistance is suggested to be closely related to the development of NAFLD11,12. Increased insulin resistance and dyslipidaemia are observed in hypothyroidism, even in subclinical hypothyroidism, and several studies have shown that subclinical hypothyroidism is related to an increased risk of metabolic syndrome[16,17,18,19]. As metabolic derangements including metabolic syndrome are associated with NAFLD development, several studies had investigated correlations between thyroid dysfunction and NAFLD. Such an association has not yet been confirmed, with some studies supporting an association between hypothyroidism and NAFLD20–25, and others not[26,27,28]. The aim of this study was to investigate the risk of NAFLD, as estimated by HSI, in subclinical hypothyroidism subjects compared to euthyroid subjects using nationally representative data
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