Abstract

Alterations in thyroid function may contribute to the development of liver fibrosis especially in subjects with non-alcoholic fatty liver disease. This study aimed to investigate the risk of liver fibrosis according to low-normal thyroid function in the general population. We performed a descriptive cross-sectional study in subjects from 18–75 years randomly selected from 16 primary health care centers from 2017–2019. Each subject underwent clinical evaluation, physical examination, blood analysis and transient hepatic elastography. Descriptive and multivariate logistic regression analyses were used to identify factors associated with fibrosis. We included 1096 subjects (60 ± 11 years; 61% women); 70% had strict-normal thyroid function and 30% had low-normal thyroid function. Low-normal thyroid function was associated with a higher liver stiffness (LS) values: 5.2 vs. 4.8 kPa (p = 0.001) and a greater prevalence of fibrosis: 6.1 vs. 3% (p = 0.016) and 4.3 vs. 2.1% (p = 0.044) for the cut-off points of ≥8.0 kPa and ≥9.2 kPa, respectively. After adjustment for potential confounding factors, the risk of fibrosis in subjects with low-normal thyroid function was OR 1.54 (p = 0.213). In conclusion, low-normal thyroid function is associated with higher LS values and a greater risk of liver fibrosis in the general population, being dependent on other metabolic factors.

Highlights

  • Liver fibrosis in subjects with chronic liver disease is a factor in bad prognosis for the development of liver cirrhosis and its consequent complications [1]

  • It was of note that among the participants with low-normal thyroid function, there was a greater prevalence of global obesity (38%; p = 0.001), abdominal obesity (57%; p = 0.002) and metabolic syndrome (MetS) (34%; p < 0.001) compared to those with strict-normal thyroid function

  • Differences were found in regard to the prevalence of non-alcoholic fatty liver disease (NAFLD) according to thyroid function, being 44% in subjects with low-normal thyroid function (p = 0.002)

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Summary

Introduction

Liver fibrosis in subjects with chronic liver disease is a factor in bad prognosis for the development of liver cirrhosis and its consequent complications [1]. The prevalence of fibrosis in the general population ranges from 3.6 to 5.8% according to the diagnostic method used [2]. The main causes of liver fibrosis are alcohol intake, viral hepatopathies and non-alcoholic fatty liver disease (NAFLD). The latter is one of the most frequent liver diseases in our setting, affecting one fourth of the population with a prevalence that has shown to be exponentially increasing in the last years due to the rise in obesity, type 2 diabetes mellitus (T2DM) and the metabolic syndrome (MetS) [3]. It is essential to identify the risk factors associated with liver fibrosis in order to approach the disease from its initial or silent stages

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