Non-alcoholic Fatty Liver Disease in Overt Hypothyroidism: A Cross-Sectional Study in a Tertiary Care Hospital

Abstract

Background: The term non-alcoholic fatty liver disease (NAFLD) describes a condition in which excess fat accumulates in the liver, similar to alcohol-induced liver injury but affecting those who don't consume alcohol. Liver steatosis may vary from simple hepatic steatosis to more serious conditions, including non-alcoholic steatohepatitis and cirrhosis, and is linked to an increased risk of hepatocellular carcinoma (HCC). There is an estimated 20-30% prevalence of non-alcoholic fatty liver disease over the globe. The incidence rate among Indians is 26.9%. Metabolic diseases like insulin resistance, obesity, type-2 diabetes mellitus, and dyslipidemia are risk factors for NAFLD. A correlation between overt hypothyroidism and NAFLD has been discussed.

Objectives: To determine the magnitude of non-alcoholic fatty liver disease in overt hypothyroidism and to estimate the clinical and biochemical profile of patients with overt hypothyroidism and its relationship.

Methods: Throughout the course of a year, researchers from the medical department of a large hospital in southern India collected data in a cross-sectional observational study. Thyroid profile, fasting lipid profile, liver function tests, and ultrasound of the abdomen and pelvis were administered to a total of 100 male and female patients (18-60 years old) with newly diagnosed overt hypothyroidism who were visiting the outpatient department (OPD) and hospitalized in wards of general medicine.

Results: About 75% of subjects were females, with a mean age of 37.63±7.6 years and a mean body mass index (BMI) of 25.07±1.5 kg/m². A significant correlation was found between dyslipidemia and thyroid-stimulating hormone (TSH) levels (p-value <0.001), and between dyslipidemia and ultrasonogram (USG) finding of NAFLD (p-value <0.001). A significant correlation was seen between TSH values and NAFLD findings (p-value <0.001).

Conclusion: NAFLD is a risk factor for developing hepatocellular carcinoma and is a known contributor to cryptogenic cirrhosis. Hypothyroidism is being studied as one of the causes of NAFLD. When hypothyroidism is diagnosed and treated early, it may reduce the likelihood of NAFLD and associated consequences.

Keywords: dyslipidaemia; hypothyroidism; medicine; nafld; tsh.