Correa-Morales A, Mancera-Sánchez J, Gutiérrez-Grobe Y, Uribe-Esquivel M, Chávez-Tapia NC, Ramos-Ostos MH, Pérez-Jáuregui JC

Language: Spanish
References: 13
Page: 660-666
PDF size: 433.65 Kb.

ABSTRACT

Background: The role of thyroid functional disorders in non-alcoholic fatty liver disease has not been completely defined. Thyroid hormones play a fundamental role in the metabolism of lipids. Hypothyroidism causes hypercholesterolemia, and has been associated with metabolic syndrome, for this reason, it could have an essential role in the pathogenesis of non-alcoholic fatty liver disease.
Objective: To find the prevalence of non-alcoholic fatty liver disease in patients with hypothyroidism.
Material and method: A case-control study was made, in which we reviewed patient’s files who had a medical preventive exam in the Diagnostic and Treatment Integral Center of Medica Sur, Mexico City, during 2012; taking as cases patients with hypothyroidism in its entire spectrum. Upper abdominal ultrasonography was used to establish the presence of fatty liver and the degree of fibrosis was calculated using the non-alcoholic fatty liver disease fibrosis score.
Results: Fatty liver disease was associated with hypothyroidism independently of whether it was in a subclinical or manifested form; it was present in a 62% in patients with hypothyroidism vs 52% in those with euthyroidism. The association between hypothyroidism and mild steatosis was significant: 51% of hypothyroid patients vs 31% of euthyroid patients (p=0.0180), and even higher for the under substituted subjects (62%, p= 0.0253).
Conclusion: Hypothyroidism can predict a mild degree of steatosis, independently of other components of the metabolic syndrome. The study strongly suggests hypothyroidism as an independent risk factor for liver steatosis since it took place in a healthy population with similar, determinant metabolic components of non-alcoholic fatty liver disease in all groups.

REFERENCES

1. Gaitonde DY, Rowlwy KD, Sweeney LB. Hypothyroidism: an update. Am Fam Phys 2012;86:244-251.

2. Lizardi-Cervera J, Laparra DI, Chavez-Tapia NC, et al. Prevalence of NAFLD and metabolic syndrome in asymptomatic subjects. Rev Gastroenterol Mex 2006;71:453-459.

3. Rodondi N, Den Elzen WPJ, Bauer DC, et al. Subclinical hypothyroidism and the risk of coronary heart disease and mortality. JAMA 2010;304:1365-1374.

4. Gutiérrez-Grobe Y, Gavilanes-Espinar JG, Masso-Rojas FA, et al. Metabolic syndrome and nonalcoholic fatty liver disease. The role of endothelial progenitor cells. Ann Hepatol 2013;12:908-914.

5. Eshraghian A, Dabbaghmanesh MH, Eshraghian H, et al. Nonalcoholic fatty liver disease in a cluster of Iranian population: thyroid status and metabolic risk factors. Arch Iran Med 2013;16:584-589.

6. Angulo P, Hui JM, Marchesini G, et al. The NAFLD fibrosis score: a noninvasive system that identifies liver fibrosis in patients with NAFLD. Hepatology 2007;45:846-854.

7. Liangpunsakul S, Chalasani N. Is hypothyroidism a risk factor non alcoholic-steatohepatitis? J Clin Gastroenterol 2003;37:340-343.

8. Silveira MG, Mendes FD, Diehl NN, et al. Thyroid dysfunction in primary biliary cirrhosis, primary sclerosing cholangitis and non alcoholic liver disease. Liver Int 2009;29:1094-1100.

9. Benvenga S, Robbins J. Enhancement of thyroxine entry into low density lipoprotein (LDL) receptor-component fibroblasts by LDL: An additional mode of entry or thyroxine into cells. Endocrinology 1990;126:933-941.

10. Chang Y, Ryu S, Sung E, et al. Higher concentrations of alanine aminotransferase within the reference interval predict nonalcoholic fatty liver disease. Clin Chem 2007;53:686- 692.

11. Xu C, Xu L, Yu C, Miao M, et al. Association between thyroid function and nonalcoholic fatty liver disease in euthyroid elderly Chinese. Clin Endocrinol 2011;75:240-246.

12. Chung GE, Kim D, Kim W et al. Non-alcoholic fatty liver disease across the spectrum of hypothyroidism. J Hepatol 2012;57:150-156.

13. Brunt EM. Nonalcoholic steatohepatitis. Semin Liver Dis 2004;24:3-20.