Association of non-alcoholic fatty liver disease with thyroid function: A systematic review and meta-analysis. Issue 11 (November 2018)

• Record Type: Journal Article
• Authors: Guo, Zeqi; Li, Miaomiao; Han, Bing; Qi, Xingshun
• Is Part Of: Digestive and liver disease. Volume 50:Issue 11(2018)
• Page Start: 1153
• Page End: 1162
• Publication Date: 2018-11
• Subjects: Hypothyroidism -- Metabolism -- Nonalcoholic steatohepatitis -- Thyroid-stimulating hormone; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; 616.33005
• DOI: 10.1016/j.dld.2018.08.012
• Languages: English
• ISSNs: 1590-8658

Abstract

Abstract: Background: Nonalcoholic fatty liver disease (NAFLD) is one of the most common chronic liver diseases. The relationship of NAFLD with thyroid function parameters and hypothyroidism remains controversial. Aim: To clarify the effect of thyroid function parameters and hypothyroidism on the development of NAFLD and progression to nonalcoholic steatohepatitis (NASH). Methods: PubMed, EMBASE, and Cochrane library databases were searched. Study quality was assessed. Weighted mean difference (WMD) and odds ratio (OR) with 95% confidence interval (CI) were calculated. Results: Twenty six studies involving 61, 548 participants were eligible, most of which were of high quality. NAFLD/NASH patients had significantly higher TSH levels than controls in adults (NAFLD versus health: WMD = 0.105, 95%CI = 0.012–0.197; NAFLD versus euthyroidism: WMD = 0.100, 95%CI = 0.005–0.194; NASH versus NAFLD: WMD = 0.540, 95%CI = 0.136–0.944) and children/adolescents (NAFLD versus lean controls: WMD = 1.039, 95%CI = 0.104–1.973; NAFLD versus overweight/obese controls: WMD = 0.485, 95%CI = 0.267–.703). Unclassified hypothyroidism was positively associated with the risk of NAFLD/NASH in adults (NAFLD versus health: OR = 1.605, 95%CI = 1.180–2.183; NASH versus NAFLD: OR = 2.317, 95%CI = 1.425–3.768) and children/adolescents (NAFLD versus overweight/obese controls: OR = 2.015, 95%CI = 1.246–3.258). However, the statistical results were inconsistent among the subgroup meta-analyses of subclinical and overt hypothyroidism. Association of NAFLD with FT3 and FT4 levels was heterogeneous among population. Conclusion: TSH level may be an important risk factor for the development and progression of NAFLD, independent of thyroid hormones.