https://www.ncbi.nlm.nih.gov/pubmed/30224316 NAFLD

Dig Liver Dis. 2018 Aug 23. pii: S1590-8658(18)30893-4. doi: 10.1016/j.dld.2018.08.012. [Epub ahead of print]
Association of non-alcoholic fatty liver disease with thyroid function: A systematic review and meta-analysis.
Guo Z1, Li M2, Han B3, Qi X4.

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.