Low thyroid function is associated with an increased risk of advanced fibrosis in patients with metabolic dysfunction-associated fatty liver disease
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Published:2023-01-05
Issue:1
Volume:23
Page:
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ISSN:1471-230X
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Container-title:BMC Gastroenterology
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language:en
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Short-container-title:BMC Gastroenterol
Author:
Fan Hong,Li Lili,Liu Zhenqiu,Zhang Pengyan,Wu Sheng,Han Xinyu,Chen Xingdong,Suo Chen,Cao Liou,Zhang Tiejun
Abstract
Abstract
Aims
Observational studies showed that low thyroid function may perturb liver function. We aimed to evaluate the association of low thyroid function with both metabolic dysfunction-associated fatty liver disease (MAFLD) and advanced hepatic fibrosis.
Methods
Participants who underwent abdominal ultrasonography and thyroid function test in a Chinese hospital from 2015 to 2021were enrolled. Fibrosis-4 index (FIB-4) > 2.67 and/or non-alcoholic fatty liver disease fibrosis score (NFS) > 0.676 were used to define advanced fibrosis. Descriptive analyses were performed to characterize the epidemiology of MAFLD according to levels of thyroid-stimulating hormone (TSH). The logistic regression model was applied to estimate the association of low thyroid function with MAFLD and advanced fibrosis.
Results
A total of 19,946 participants (52.78% males, mean age: 47.31 years, 27.55% MAFLD) were included, among which 14,789 were strict-normal thyroid function, 4,328 were low-normal thyroid function, 829 were subclinical hypothyroidism. TSH levels were significantly higher in MAFLD patients with a FIB-4 > 2.67 and /or NFS > 0.676 than their counterparts. The logistic regression model adjusted for age and sex showed that low-normal thyroid function increased the risk of MAFLD (odds ratio [OR] = 1.09; 95% confidence interval [CI] 1.01–1.18). Multivariable regression model adjusted for age, sex, body mass index, type 2 diabetes, and hypertension showed low-normal thyroid function increased the risk of advanced fibrosis in patients with MAFLD (FIB-4 > 2.67: OR = 1.41, 95% CI 1.02–1.93; NFS > 0.676: OR = 1.72, 95% CI 1.08–2.72).
Conclusion
Elevated TSH concentrations are associated with advanced hepatic fibrosis, even in the euthyroid state.
Funder
the Special Foundation for Science and Technology Basic Research Program the National Key Research and Development Program of China the Three-Year Action Plan for Strengthening Public Health System in Shanghai an Innovation Grant from Science and Technology Commission of Shanghai Municipality, China the Natural Science Foundation of China
Publisher
Springer Science and Business Media LLC
Subject
Gastroenterology,General Medicine
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