Thyroid Profile of Patients with Non-alcoholic Fatty Liver Disease

  • Paul Samaresh Agartala Government Medical College, Agartala, Tripura, India
  • Bhaumik Pradip Agartala Government Medical College, Agartala, Tripura, India
  • Bhattacharya Swatilekha Agartala Government Medical College, Agartala, Tripura, India
Keywords: Hypothyroid, Non-alcoholic fatty liver disease, Subclinical hypothyroid, Transaminase

Abstract

Introduction: Non-alcoholic fatty liver disease (NAFLD) is associated with various metabolic abnormalities such as obesity, insulin resistance, and dyslipidemia. The prevalence of NAFLD is increasing gradually, which may progress to non-alcoholic steatohepatitis (NASH), cirrhosis of liver, and hepatocellular carcinoma. The important association of NAFLD and metabolic disease can lead to endocrinopathy, including thyroid diseases.
Methodology: Serologically diagnosed NAFLD patient was evaluated biochemically for liver function and thyroid function to evaluate any association between these two.
Results: The study shows female preponderance (63.3%) NAFLD. It was observed that 77.50% were having normal transaminase level and 22.50% had raised transaminase levels (NASH). Subclinical hypothyroidism was present among 18.30%, overt hypothyroidism was 7.50%, and hyperthyroidism was 0.80%. Among the individuals with normal transaminase level, 20.50% were hypothyroid (15.10% subclinical and 5.40% overt), and persons with raised transaminase levels (NASH), 44.44% were hypothyroid (29.63% subclinical and 14.81% overt).
Conclusion: This study shows that though there was a female preponderance of NAFLD, raised transaminase was more common among male and so is the hypothyroidism. This may form a matrix to the future study for cause and effect relationship of NAFLD and thyroid disease.

Author Biographies

Paul Samaresh, Agartala Government Medical College, Agartala, Tripura, India

Post Graduate Resident, Department of Medicine, 

Bhaumik Pradip, Agartala Government Medical College, Agartala, Tripura, India

Associate Professor, Department of Medicine, 

Bhattacharya Swatilekha, Agartala Government Medical College, Agartala, Tripura, India

Junior Research Fellowships, Medical Research Center, 

References

1. Abdelmalek MF, Diel AM. Harrison’s Principles of Internal Medicine.
19th ed. New York: McGraw Hill Education; 2015. p. 2052-4.
2. Brunt EM. Histological assessment of nonalcoholic fatty liver disease in
adults and children. Clin Liver Dis (Hoboken) 2012;1:108-11.
3. Musso G, Gambino R, Cassader M. Non-alcoholic fatty liver disease from
pathogenesis to management: An update. Obes Rev 2010;11:430-45.
4. Oh HJ, Kim TH, Sohn YW, Kim YS, Oh YR, Cho EY, et al. Association
of serum alanine aminotransferase and γ-glutamyltransferase levels within
the reference range with metabolic syndrome and nonalcoholic fatty liver
disease. Korean J Hepatol 2011;17:27-36.
5. Starley BQ, Calcagno CJ, Harrison SA. Nonalcoholic fatty liver disease
and hepatocellular carcinoma: A weighty connection. Hepatology
2010;51:1820-32.
6. Vuppalanchi R, Chalasani N. Nonalcoholic fatty liver disease and
nonalcoholic steatohepatitis: Selected practical issues in their evaluation
and management. Hepatology 2009;49:306-17.
7. Frith J, Day CP, Henderson E, Burt AD, Newton JL. Non-alcoholic fatty
liver disease in older people. Gerontology 2009;55:607-13.
8. Xu C, Xu L, Yu C, Miao M, Li Y. Association between thyroid function
and nonalcoholic fatty liver disease in euthyroid elderly Chinese. Clin
Endocrinol (Oxf) 2011;75:240-246.
9. Zelber-Sagi S, Nitzan-Kaluski D, Halpern Z, Oren R. Prevalence of
primary non-alcoholic fatty liver disease in a population-based study and
its association with biochemical and anthropometric measures. Liver Int
2006;26:856-63.
10. Abdelmalek MF, Diel AM. Harrison’s Principles of Internal Medicine.
19th ed. New York: McGraw Hill Education; 2015. p. 2052-4.
11. Anstee QM, McPherson S, Day CP. How big a problem is non-alcoholic
fatty liver disease? BMJ 2011;343:d3897.
12. Bookman ID, Pham J, Guindi M, Heathcote EJ. Distinguishing nonalcoholic
steatohepatitis from fatty liver: Serum-free fatty acids, insulin resistance,
and serum lipoproteins. Liver Int 2006;26:566-71.
13. Papandreou D, Rousso I, Mavromichalis I. Update on non-alcoholic fatty
liver disease in children. Clin Nutr 2007;26:409-15.
14. Angulo P. Nonalcoholic fatty liver disease. N Engl J Med 2002;346:1221-31.
15. Kotronen A, Yki-Järvinen H. Fatty liver: A novel component of the
metabolic syndrome. Arterioscler Thromb Vasc Biol 2008;28:27-38.
16. Dietrich JW, Landgrafe G, Fotiadou EH. TSH and thyrotropic agonists: Key
actors in thyroid homeostasis. J Thyroid Res 2012;2012:351864.
17. Chung GE, Kim D, Kim W, Yim JY, Park MJ, Kim YJ, et al. Non-alcoholic
fatty liver disease across the spectrum of hypothyroidism. J Hepatol
2012;57:150-156.
18. Liangpunsakul S, Chalasani N. Is hypothyroidism a risk factor for nonalcoholic
steatohepatitis? J Clin Gastroenterol 2003;37:340-343.
19. Pagadala MR, Zein CO, Dasarathy S, Yerian LM, Lopez R, McCullough AJ.
Prevalence of hypothyroidism in nonalcoholic fatty liver disease. Dig Dis
Sci 2012;57:528-534.
20. Xu L, Ma H, Miao M, Li Y. Impact of subclinical hypothyroidism on
the development of non-alcoholic fatty liver disease: A prospective casecontrol
study. J Hepatol 2012;57:1153-4.
21. Loria P, Carulli L, Bertolotti M, Lonardo A. Endocrine and liver interaction:
The role of endocrine pathways in NASH. Nat Rev Gastroenterol Hepatol
2009;6:236-47.
22. Ineck BA, Ng TM. Effects of subclinical hypothyroidism and its treatment
on serum lipids. Ann Pharmacother 2003;37:725-30.
23. Kratz A, Pesce MA, Basner RC, Einstein AJ. Harrison’s Principles of
Internal Medicine. 19th ed. Pushpa Man Shrestha Ayurved Campus TU,
Kirtipur, Nepal: Mc Graw Hill Education; 2015. p. 2757.
24. Hollowell JG, Staehling NW, Flanders WD, Hannon WH, Gunter EW,
Spencer CA, et al. Serum TSH, T(4), and thyroid antibodies in the United
States population (1988 to 1994): National health and nutrition examination
survey (NHANES III). J Clin Endocrinol Metab 2002;87:489-99.
25. Chung GE, Kim D, Kim W, Yim JY, Park MJ, Kim YJ, et al. Non-alcoholic
fatty liver disease across the spectrum of hypothyroidism. J Hepatol
2012;57:150-6.
Published
2021-09-10