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Meta-Analysis
. 2024 Jun 25:15:1399517.
doi: 10.3389/fendo.2024.1399517. eCollection 2024.

Association between thyroid function and nonalcoholic fatty liver disease: a dose-response meta-analysis

Liu-Lan Xiang  1   2 , Yu-Tian Cao  1   2 , Jing Sun  1   2 , Rui-Han Li  1   2 , Fang Qi  1   2 , Yu-Juan Zhang  1   2 , Wen-Hui Zhang  1   2 , Lou Yan  1 , Xi-Qiao Zhou  1
Affiliations
Meta-Analysis

Association between thyroid function and nonalcoholic fatty liver disease: a dose-response meta-analysis

Liu-Lan Xiang et al. Front Endocrinol (Lausanne). .

Abstract

Background: Thyroid hormones (THs) have been found that it is closely associated with the onset and progression of non-alcoholic fatty liver disease (NAFLD). However, the current study could not verify the intrinsic relationship between thyroid hormones and NAFLD, which requires further research.

Methods: The searches of studies reported both TH level in serum and NAFLD were performed in PubMed, Web of Science, Cochrane Library, and Embase databases. We combined an overall meta-analysis with a dose-response meta-analysis to assess the correlation and dose-response relationship between thyroid function levels and the risk of NAFLD.

Results: Overall, 10 studies were included with a total of 38,425 individuals. We found that the non-linear dose-response model showed that for every 1 ng/dL increase in FT4, the risk of NAFLD was reduced by 10.56% (p=0.003). The odds ratios (ORs) for NAFLD with high free triiodothyronine (FT3) exposure compared to those with low FT3 were 1.580 (95% CI 1.370 to 1.830, I2 = 0.0%, p<0.001) in the overall meta-analysis. The continuous variable meta-analysis indicated that individuals with high levels of TSH (SMD=1.32, 95% CI 0.660 to 1.970, p<0.001) had significantly higher levels of liver fibrosis than those with low levels.

Conclusions: Our findings only validate that there is a correlation between the occurrence of NAFLD and abnormal levels of THs, and it is expected that more observational studies will still be conducted in the future to further demonstrate the relationship between thyroid hormones and NAFLD.

Trial registration: Registered number in PROSPERO: CRD42023405052.

Keywords: dose-response; meta - analysis; nonalcoholic fatty liver disease; systematic evaluation; thyroid function.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram of study selection process.
Figure 2
Figure 2
Forest plot of the risk of NAFLD associated with Thyroid hormones. (A) Association between TSH and risk of NAFLD. (B) Association between FT4 and risk of NAFLD. (C) Association between FT3 and risk of NAFLD. The hollow diamond represents the merged OR. The error bar represents a 95% confidence interval.
Figure 3
Figure 3
Dose response relationship between TSH, FT4 level and NAFLD risk. (A) Dose-response relationship between TSH levels and relative risk of NAFLD. (B) Dose-response relationship between FT4 levels and relative risk of NAFLD.
Figure 4
Figure 4
Forest plot of NAFLD liver cirrhosis index associated with Thyroid hormones. (A) Association between TSH and NAFLD liver cirrhosis index. (B) Association between FT4 and NAFLD liver cirrhosis index. (C) Association between FT3 and NAFLD liver cirrhosis index. The hollow diamond represents the merged SMD. The error bar represents a 95% confidence interval.
Figure 5
Figure 5
Dose response relationship between TSH, FT4 level and NAFLD liver cirrhosis index. (A) Dose-response relationship between TSH levels and NAFLD liver cirrhosis index. (B) Dose-response relationship between FT4 levels and NAFLD liver cirrhosis index.
Figure 6
Figure 6
Subgroup analyses. (A) Subgroup analyses of TSH levels and relative risk of NAFLD. (B) Subgroup analyses of FT4 levels and relative risk of NAFLD. (C) Subgroup analysis of TSH levels versus NAFLD liver cirrhosis index. (D) Subgroup analysis of FT4 levels versus NAFLD liver cirrhosis index.
See this image and copyright information in PMC

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