Prevalence of hypothyroidism in nonalcoholic fatty liver disease
Open accessAbstract
Background A possible association between nonalcoholic fatty liver disease (NAFLD) and hypothyroidism has been suggested. The recognized link between hypothyroidism and elements of the metabolic syndrome may explain this association.Aim The purpose of this study was to determine the prevalence of hypothyroidism in a cohort of patients with NAFLD and analyze the potential factors associated with hypothyroidism in this patient population.Methods Two hundred forty-six patients with biopsy-proven NAFLD attending hepatology clinics at the Cleveland Clinic between October 2006 and June 2009, and 430 age-, gender-, race- and BMI-matched control subjects seen in the general internal medicine clinic were included. Patients with a clinical diagnosis of hypothyroidism who were on thyroid replacement therapy were considered to be hypothyroid.Results Hypothyroidism was more frequent among patients with NAFLD (21% vs. 9.5%; P < 0.01) compared to controls, and was higher in NASH patients than NAFLD patients without NASH (25% vs. 12.8%, P = 0.03). Subjects with hypothyroidism were 2.1 (95% CI 1.1-3.9, P = 0.02) and 3.8 (95% CI 2-6.9, P < 0.001) times more likely to have NAFLD and NASH, respectively. By multivariate analysis, female gender (P < 0.001) and increased BMI (P = 0.03) were associated with hypothyroidism. NAFLD subjects who reported mild alcohol consumption were less likely to have hypothyroidism compared to those who reported complete abstinence (OR 0.37, P = 0.008).Conclusions A higher prevalence of hypothyroidism was demonstrated in patients with NAFLD compared to controls. Among subjects with NALFD, female gender, increased BMI and history of abstinence from alcohol were associated with hypothyroidism. Patients with hypothyroidism were also more likely to have NASH.
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NAFLD progression is associated with hypothyroidism, whereas hyperthyroidism appears to slow down fibrotic remodeling in the liver of NAFLD patients.
“Interestingly, NAFLD progression was associated with hypothyroidism, whereas hyperthyroidism appeared to slow down fibrotic remodeling in the liver of NAFLD patients.[190,191]”
From Nuclear receptors in liver fibrosis (2021) · cites this paper as [190]
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- Authors
- Pagadala, M. R., Zein, C. O., Dasarathy, S., Yerian, L. M., Lopez, R., & McCullough, A. J.
- Affiliations
- Cleveland Clinic (US)
- Cleveland Clinic Lerner College of Medicine (US)
- Corresponding author
- McCullough, Arthur J.
- Venue
- Digestive Diseases and Sciences
- Published
- 2011-12-20
- Volume
- 57
- Issue
- 2
- Pages
- 528-534
- ISSN
- 0163-2116 (ISSN-L)
- 1573-2568
- PMC
- PMC3922233
- OpenAlex
- W2062964646
- Cited by
- 178
- References
- 56
- Citations by year
- 2026: 4 · 2025: 11 · 2024: 13 · 2023: 7 · 2022: 17 · 2021: 24 · 2020: 17 · 2019: 19 · 2018: 15 · 2017: 8 · 2016: 11 · 2015: 10 · 2014: 11 · 2013: 8 · 2012: 3
- FWCI
- 5.28
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Digestive Diseases and Sciences (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (5kl2rr024990-05)
- National Institute of Diabetes and Digestive and Kidney Diseases (T32DK061917, DK 061732, T32DK083251, U01DK061732)
- National Center for Research Resources (KL2-RR-024990)
- Topics
- Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Keywords
- hypothyroidism, non-alcoholic fatty liver disease, nonalcoholic steatohepatitis, prevalence, metabolic syndrome, body mass index, female sex, alcohol consumption, thyroid hormone replacement
- MeSH terms
- Adult, Fatty Liver, Female, Humans, Hypothyroidism, Insulin Resistance, Male, Middle Aged, Comorbidity, Prevalence, Multivariate Analysis, Metabolic Syndrome, Non-alcoholic Fatty Liver Disease
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