PMID- 35582287
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220716
IS  - 1948-5182 (Print)
IS  - 1948-5182 (Electronic)
VI  - 14
IP  - 3
DP  - 2022 Mar 27
TI  - Prevalence of hypothyroidism and effect of thyroid hormone replacement therapy in 
      patients with non-alcoholic fatty liver disease: A population-based study.
PG  - 551-558
LID - 10.4254/wjh.v14.i3.551 [doi]
AB  - BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is currently considered as 
      the most common cause of chronic liver disease worldwide. Risk factors for NAFLD 
      have been well-described, including obesity, type 2 diabetes mellites (T2DM), 
      dyslipidemia (DLP) and metabolic syndrome. Hypothyroidism has been identified as 
      an independent risk factor for the development of NAFLD, although the literature 
      is inconsistent. AIM: To evaluate the prevalence of hypothyroidism in patients 
      with NAFLD, assess if it is an independent risk factor and explore the effect of 
      thyroxine replacement therapy. METHODS: Our cohort's data was obtained using a 
      validated, large, multicenter database (Explorys Inc, Cleveland, OH, United 
      States) aggregated from pooled outpatient and inpatient records of 26 different 
      healthcare systems, consisting of a total of 360 hospitals in the United States, 
      and utilizing Systematized Nomenclature of Medicine-Clinical Terms for coding. We 
      evaluated a cohort of patients with hypothyroidism and NAFLD. Multivariate 
      analysis was performed to adjust for confounding risk factors including 
      hypertension (HTN), T2DM, DLP, obesity and metabolic syndrome. SPSS version 25, 
      IBM Corp was used for statistical analysis, and for all analyses, a 2-sided P 
      value of < 0.05 was considered statistically significant. Exclusion criteria were 
      limited to age < 18 years. RESULTS: Among the 37648180 included individuals in 
      this database who are above the age of 18 years, there were a total of 2320 
      patients with NAFLD (6.16 per 100000) in the last five years (2015-2020), amongst 
      which 520 patients (22.4%) had hypothyroidism. Baseline characteristics of 
      patients in this database are described in Table 1. Patients with NAFLD were also 
      more likely to have obesity, T2DM, DLP, HTN, and metabolic syndrome (Table 2). 
      While males and females were equally affected, patients in the age group 18-65 
      years as well as Caucasians seem to be at a higher risk. There was an increased 
      risk of NAFLD among patients with hypothyroidism (OR = 1.587). Furthermore, 
      thyroid hormone replacement was not associated with a decreased risk for 
      developing NAFLD (OR = 1.106, C = 0.952-1.285, P = 0.303). CONCLUSION: 
      Hypothyroidism seems to be an independent risk factor for the development of 
      NAFLD. Thyroid hormone replacement did not provide a statistically significant 
      risk reduction. Further studies are needed to evaluate the effect of thyroid 
      hormone replacement and assess if being euthyroid while on thyroid replacement 
      therapy affects development and/or progression of NAFLD.
CI  - (c)The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights 
      reserved.
FAU - Almomani, Ashraf
AU  - Almomani A
AD  - Department ofInternal Medicine, Cleveland Clinic Foundation, Cleveland, OH 44111, 
      United States.
FAU - Hitawala, Asif Ali
AU  - Hitawala AA
AD  - Liver Disease Branch, National Institute of Diabetes and Digestive and Kidney 
      Diseases/National Institutes of Health, Bethesda, MD 20892, United States.
FAU - Kumar, Prabhat
AU  - Kumar P
AD  - Department ofInternal Medicine, Cleveland Clinic Foundation, Cleveland, OH 44111, 
      United States.
FAU - Alqaisi, Sura
AU  - Alqaisi S
AD  - Department ofInternal Medicine, Cleveland Clinic Foundation, Cleveland, OH 44111, 
      United States.
FAU - Alshaikh, Dana
AU  - Alshaikh D
AD  - Mutah University, Amman 00962, Jordan.
FAU - Alkhayyat, Motasem
AU  - Alkhayyat M
AD  - Department ofInternal Medicine, Cleveland Clinic Foundation, Cleveland, OH 44111, 
      United States.
FAU - Asaad, Imad
AU  - Asaad I
AD  - Department of Digestive Disease and Surgery Institute, Cleveland Clinic 
      Foundation, Cleveland, OH 44195, United States. asaadi@ccf.org.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - World J Hepatol
JT  - World journal of hepatology
JID - 101532469
PMC - PMC9055192
OTO - NOTNLM
OT  - Hypothyroidism
OT  - Independent risk factor
OT  - Non-alcoholic fatty liver disease
OT  - Thyroid hormone replacement therapy
COIS- Conflict-of-interest statement: No conflict of interest.
EDAT- 2022/05/19 06:00
MHDA- 2022/05/19 06:01
PMCR- 2022/03/27
CRDT- 2022/05/18 02:08
PHST- 2021/08/16 00:00 [received]
PHST- 2021/11/13 00:00 [revised]
PHST- 2022/02/24 00:00 [accepted]
PHST- 2022/05/18 02:08 [entrez]
PHST- 2022/05/19 06:00 [pubmed]
PHST- 2022/05/19 06:01 [medline]
PHST- 2022/03/27 00:00 [pmc-release]
AID - 10.4254/wjh.v14.i3.551 [doi]
PST - ppublish
SO  - World J Hepatol. 2022 Mar 27;14(3):551-558. doi: 10.4254/wjh.v14.i3.551.