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NAFLD associated with presence, severity of hypothyroidism

Patients with hypothyroidism may be more prone to nonalcoholic fatty liver disease, according to recent study results.

In a cross-sectional study, researchers evaluated 2,324 patients with either subclinical hypothyroidism (n=2,189) or overt hypothyroidism (n=135) along with 2,324 matched controls with euthyroidism. The presence of NAFLD was established via ultrasonography and participants’ alcohol consumption habits.

Significantly more patients with hypothyroidism had NAFLD than those in the control group (30.2% vs. 19.5%, P<.001), and abnormal alanine aminotransferase (ALT) levels (>33 IU/L for men; >25 IU/L for women) and NAFLD prevalence increased with the severity of hypothyroidism. NAFLD was present in 29.9% of patients with subclinical hypothyroidism compared with 36.3% of those with overt hypothyroidism (P<.001), while abnormal ALT occurred in 20.1% of subclinical patients compared with 25.9% of overt patients (P<.001). The presence of NAFLD and abnormal ALT also was significantly more frequent in patients with hypothyroidism than in patients with euthyroidism (11.0% vs. 7.3%, P<.001).

Investigators found an independent association between NAFLD and hypothyroidism through multivariate analysis adjusting for known risk factors (OR=1.38; 95% CI, 1.17-1.62). A dose-dependent association also was established between NAFLD and subclinical hypothyroidism (OR=1.36; 95% CI, 1.16-1.61) and overt hypothyroidism (OR=1.71; 95% CI, 1.10-2.66).

“Our study suggests that hypothyroidism is related to an increased prevalence of NAFLD and that the spectrum of hypothyroidism is associated with NAFLD in a dose-dependent manner,” the researchers wrote. “NAFLD is closely associated with hypothyroidism independently of known metabolic risk factors, thereby confirming a relevant clinical relationship between these two diseases.”