Non-alcoholic fatty liver disease across the spectrum of hypothyroidism

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• 作者：Goh Eun Chung¹ ; Donghee Kim¹ ; ^{messmd@chol.com} ; Won Kim² ; Jeong Yoon Yim¹ ; Min Jung Park¹ ; Yoon Jun Kim³ ; Jung-Hwan Yoon³ ; Hyo-Suk Lee³
• 关键词：NAFLD ; non-alcoholic fatty liver disease ; TSH ; thyroid-stimulating hormone ; T4 ; thyroxine ; BMI ; body mass index ; ALT ; alanine aminotransferase ; AST ; aspartate aminotransferase ; HDL ; high density lipoprotein ; OR ; odds ratio ; CI ; confidence interval
• 刊名：Journal of Hepatology
• 出版年：2012
• 期刊代码：162_01688278
• 类别：med
• 出版时间：July, 2012
• 卷：57
• 期：1
• 页码：150-156
• 文件大小：763 K

摘要

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Background & Aims

The aim of this study was to characterize the relationship between the broad spectrum of hypothyroidism and NAFLD.

Methods

A cross-sectional study with 4648 health check-up subjects (2324 cases with hypothyroidism vs. age- and sex-matched controls) was conducted. The subjects were categorized as having either subclinical [thyroid-stimulating hormone (TSH) 猢?.1 mIU/L and normal free thyroixine (T₄) level (0.7-1.8 ng/dl)] or overt hypothyroidism [free T₄ <0.7 ng/dl]. NAFLD was diagnosed on the basis of typical ultrasonographic findings, and alcohol consumption of less than 20 g/day in the absence of other causes of liver disease.

Results

The mean age of the subjects was 48.6 卤 11.8 years and 62.4%were female. NAFLD was significantly associated with hypothyroidism (30.2%patients vs. 19.5%control, p <0.001). The prevalence of NAFLD and abnormal liver enzyme levels (ALT >33/25 IU/L) increased steadily with increasing grades of hypothyroidism (for NAFLD, subclinical: 29.9%and overt: 36.3%; for abnormal ALT, 20.1%and 25.9%, p <0.001, respectively). Multivariate regression analysis showed that NAFLD was statistically significantly associated with hypothyroidism (odds ratio (OR) 1.38, 95%confidence interval (CI), 1.17-1.62) and the grade of hypothyroidism in a dose-dependent manner (OR 1.36, 95%CI, 1.16-1.61 in subclinical hypothyroidism and OR 1.71, 95%CI, 1.10-2.66 in overt hypothyroidism).

Conclusions

Subclinical hypothyroidism, even in the range of upper normal TSH levels, was found to be related to NAFLD in a dose-dependent manner. Hypothyroidism is closely associated with NAFLD independently of known metabolic risk factors, confirming a relevant clinical relationship between these two diseases.