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Thyroid stimulating hormone linked to risk of NALFD development, progression

29 Oct 2018

Thyroid-stimulating hormone (TSH) levels may be associated with the risk of nonalcoholic fatty liver disease (NAFLD) and its progression into nonalcoholic steatohepatitis (NASH), a recent meta-analysis has shown.

Twenty-six studies were eligible for inclusion corresponding to a cumulative sample size of 61,548 participants. Pooled analysis of 11 studies (n=47,217) showed that TSH levels were significantly higher in NAFLD patients than in healthy controls (weighted mean difference [WMD], 0105; 95 percent CI, 0.012–0.197; p=0.027). Heterogeneity of evidence was significant (p<0.001).

The effect of TSH on NAFLD remained significant even when healthy controls were compared to adults with euthyroidism alone (five studies; n=25,754; WMD, 0.100; 0.005–0.194; p=0.038). The same was true in lean (WMD, 1.039; 0.104–1.973) and overweight/obese (WMD, 0.485; 0.267–0.703; p<0.001) children regardless of thyroid function.

Similarly, the prevalence rate of unclassified hypothyroidism was significantly higher in adults with NAFLD than in healthy controls (odds ratio [OR], 1.605; 1.180–2.183; p=0.003).

Only one study (n=69) examined the potential effect of TSH on the progression of NAFLD. This found that NASH vs NAFLD patients had significantly elevated levels of TSH (WMD, 0.549; 0.136–0.944; p=0.009).

In terms of other biomarkers, there were no significant differences in concentrations of free and total thyroxine and triiodothyronine among healthy controls and adult NAFLD patients regardless of thyroid function. The prevalence of subclinical hypothyroidism was likewise statistically comparable between NAFLD patients and controls (OR, 1.251; 0.906–1.727; p=0.174).

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