ArticlePloS one2021
The relationship between liver histology and thyroid function tests in patients with non-alcoholic fatty liver disease (NAFLD).
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.
- Association between thyroid function and metabolic associated fatty liver disease: a systemic review and meta-analysis.Frontiers in endocrinology · 2025Pooled it
- A multipart phase 1 study of the safety, pharmacodynamics and pharmacokinetics of ALG-055009, a novel thyroid hormone receptor beta (THR-β) agonist for metabolic dysfunction-associated steatohepatitis (MASH), in healthy participants.Clinical pharmacology in drug development · 2026Trial
- Impact of thyroid dysfunction and diabetes on fibrosis and steatosis stages in metabolic dysfunction associated fatty liver disease.Scientific reports · 2025Article
- The clinical implications of the interaction between hypothyroidism and diabetes mellitus.Scientific reports · 2025Article
- Thyroid dysfunction in MASLD: Results of a nationwide study.JHEP reports : innovation in hepatology · 2025Article
- Thyroid function and hepatic fibrosis/cirrhosis: a two-sample Mendelian randomization study.Frontiers in genetics · 2025Article
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- Article
- Current Therapeutical Approaches Targeting Lipid Metabolism in NAFLD.International journal of molecular sciences · 2023Review
- MAFLD: a multisystem disease.Therapeutic advances in endocrinology and metabolism · 2023Review
- Association between Thyroid Hormones and Non-alcoholic Fatty Liver Disease and Non-alcoholic Steatohepatitis in Obese Individuals Undergoing Bariatric Surgery.Middle East journal of digestive diseases · 2022Article
- Influence of Altered Thyroid Hormone Mechanisms in the Progression of Metabolic Dysfunction Associated with Fatty Liver Disease (MAFLD): A Systematic Review.Metabolites · 2022Review
- The Role of Insulin Resistance in Fueling NAFLD Pathogenesis: From Molecular Mechanisms to Clinical Implications.Journal of clinical medicine · 2022Review
- The protective effect of hesperidin on the liver of hypothyroid rats mediated by nuclear factor erythroid 2-related factor 2-dependent activation of heme oxygenase 1.Journal of molecular histology · 2022Article
- Hypothyroidism and Diabetes-Related Dementia: Focused on Neuronal Dysfunction, Insulin Resistance, and Dyslipidemia.International journal of molecular sciences · 2022Review
- Targeting Thyroid Hormone/Thyroid Hormone Receptor Axis: An Attractive Therapy Strategy in Liver Diseases.Frontiers in pharmacology · 2022Review
- Hypothyroidism-Associated Dyslipidemia: Potential Molecular Mechanisms Leading to NAFLD.International journal of molecular sciences · 2021Review
- TSH Levels as an Independent Risk Factor for NAFLD and Liver Fibrosis in the General Population.Journal of clinical medicine · 2021Article
Corrections and comments
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Authors and funding
12 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundData on the role of hypothyroidism in the pathogenesis of non-alcoholic fatty liver disease (NAFLD) and liver fibrosis are conflicting, although selective Thyroid Hormone Receptor (THR)-β agonists have been identified as potential therapy in patients with non-alcoholic steatohepatitis (NASH). Therefore, we investigated the association between hypothyroidism and NAFLD histological features potentially associated with progressive liver disease.
methodsBetween 2014 and 2016, consecutive patients with histologically proven NAFLD and frozen serum available for thyroid function tests assessment were included. NAFLD was staged according to the NAFLD Activity Score (NAS), and fibrosis according to Kleiner. NASH was defined as NAS ≥4, significant fibrosis as F2-F4 and significant steatosis as S2-S3. Thyroid function tests (TFT; TSH, FT3, FT4, rT3), TPO-Ab and Tg-Ab were also assessed.
resultsFifty-two patients were analyzed: median age 54 years, 58% females, LSM 7.8 kPa, 27% diabetics, 14% hypothyroid. At histology, NASH was present in 21 (40%), F2-F4 in 28 (54%) and S2-S3 in 30 (58%) patients. Rates of hypothyroidism were similar independently of the presence of NASH (p = 0.11), significant fibrosis (p = 0.21) or steatosis (p = 0.75). However, hypothyroid patients displayed a higher NAS (p = 0.02) and NASH (p = 0.06) prevalence. At multivariate analysis, TFT were not independently associated with histology.
conclusionHypothyroidism was highly prevalent in NAFLD patients, and was associated with increased NAFLD activity, but not with fibrosis and steatosis severity. Thus, thyroid dysfunction might play a direct and/or indirect in the pathogenesis of NAFLD and NASH.
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