Abstract
Thyroid hormones may be a risk factor for the development of non-alcoholic fatty liver disease (NAFLD) and its progression to liver fibrosis. The aim of this study is to investigate the relationship between thyroid stimulating hormone (TSH) levels, NAFLD, and liver fibrosis in the general population. A descriptive cross-sectional study was performed in subjects aged 18–75 years randomly selected from primary care centers between 2012 and 2016. Each subject underwent clinical evaluation, physical examination, blood tests and transient elastography. Descriptive and multivariate logistic regression analyses were used to identify factors associated with NAFLD and fibrosis. We included 2452 subjects (54 ± 12 years; 61% female). Subjects with TSH ≥ 2.5 μIU/mL were significantly associated with obesity, atherogenic dyslipidemia, metabolic syndrome (MetS), hypertransaminasemia and altered cholesterol and triglycerides. The prevalence of NAFLD and liver fibrosis was significantly higher in subjects with TSH ≥ 2.5 (μIU/mL). We found a 1.5 times increased risk of NAFLD, 1.8 and 2.3 times increased risk of liver fibrosis for cut-off points of ≥8.0 kPa and ≥9.2 kPa, respectively, in subjects with TSH ≥ 2.5 μIU/mL compared with TSH < 2.5 μIU/mL (control group), independent of the presence of MetS. These findings remained significant when stratifying TSH, with values ≥ 10 μIU/mL.
Highlights
Non-alcoholic fatty liver disease (NAFLD) has become a major public health problem in recent decades, being the most common liver disease worldwide, with a prevalence between 25% and 30% of the adult population [1]
The main cause of the increase in its prevalence is the close relationship between non-alcoholic fatty liver disease (NAFLD) and different metabolic disorders, such as obesity, type 2 diabetes (T2DM), hypertriglyceridemia or metabolic syndrome (MetS), which in turn affect a large number of subjects today [2]
The individuals were classified according to thyroid stimulating hormone (TSH) levels into two groups: 66% with TSH < 2.5 μIU/mL (n = 1619) and 44% with TSH ≥ 2.5 μIU/mL (n = 833)
Summary
Non-alcoholic fatty liver disease (NAFLD) has become a major public health problem in recent decades, being the most common liver disease worldwide, with a prevalence between 25% and 30% of the adult population [1]. The heterogenicity in the distribution of the disease according to sub-populations with metabolic risk factors has led to a rethinking, even in the nomenclature of NAFLD, with the aim of identifying those patients with a higher risk of liver progression [3]. The main characteristic of NAFLD is fatty infiltration in more than 5% of hepatocytes, which is known as simple steatosis, in the absence of other chronic liver diseases (viral, alcoholic, drug, autoimmune) [4]. Later, this disease can progress to steatohepatitis, with different degrees of affectation, leading to the development of advanced liver fibrosis in. Detecting liver fibrosis early is crucial as the severity of fibrosis predicts the development of liver cirrhosis and long-term survival
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