Arjola Bano1, Layal Chaker1, Elisabeth P C Plompen1, Albert Hofman1, Abbas Dehghan1, Oscar H Franco1, Harry L A Janssen1, Sarwa Darwish Murad1, Robin P Peeters1. 1. Department of Internal Medicine (A.B., L.C., R.P.P.), Erasmus University Medical Center, 3015 GE, Rotterdam, The Netherlands; Rotterdam Thyroid Center (A.B., L.C., R.P.P.), Erasmus University Medical Center, 3015 GE, Rotterdam, The Netherlands; Department of Epidemiology (A.B., L.C., E.P.C.P., A.H., A.D., O.H.F., S.D.M., R.P.P.), Erasmus University Medical Center, 3015 GE, Rotterdam, The Netherlands; Department of Gastroenterology and Hepatology (E.P.C.P., H.L.A.J., S.D.M.), Erasmus University Medical Center, 3015 GE, Rotterdam, The Netherlands; and Toronto Centre for Liver Disease (H.L.A.J.), Toronto Western and General Hospital, University Health Network, Toronto, Ontario, M5G 2C4 Canada.
Abstract
CONTEXT: Although thyroid function is associated with several risk factors of nonalcoholic fatty liver disease (NAFLD), its role in NAFLD development remains unclear. OBJECTIVE: We aimed to prospectively investigate the association between variations in thyroid function and NAFLD. DESIGN AND SETTING: The Rotterdam Study, a large population-based, prospective cohort study. PARTICIPANTS AND MAIN OUTCOME MEASURES: Participants with thyroid function measurements at baseline and NAFLD data (ie, at baseline fatty liver index/at follow-up ultrasound) were eligible. Transient elastography was performed to assess the presence of fibrosis in patients with NAFLD, using the liver stiffness measurements more than or equal to 8 kPa as cutoff for clinically relevant fibrosis. The association between thyroid parameters and incident NAFLD was explored by using logistic regression models. RESULTS: A total of 9419 participants (mean age, 64.75 y) were included. The median follow-up time was 10.04 years (interquartile range, 5.70-10.88 y). After adjusting for age, sex, cohort, follow-up time, use of hypolipidemic drugs, and cardiovascular risk factors, higher free T4 levels were associated with a decreased risk of NAFLD (odds ratio, 0.42; 95% confidence interval [CI], 0.28-0.63). In line, higher TSH levels were associated with an increased risk of having clinically relevant fibrosis in NAFLD (odds ratio, 1.49; CI, 1.04-2.15). Compared with euthyroidism, hypothyroidism was associated with a 1.24-fold higher NAFLD risk (CI, 1.01-1.53). Moreover, NAFLD risk decreased gradually from hypothyroidism to hyperthyroidism (P for trend = .003). CONCLUSION: Lower thyroid function is associated with an increased NAFLD risk. These findings may lead to new avenues regarding NAFLD prevention and treatment.
CONTEXT: Although thyroid function is associated with several risk factors of nonalcoholic fatty liver disease (NAFLD), its role in NAFLD development remains unclear. OBJECTIVE: We aimed to prospectively investigate the association between variations in thyroid function and NAFLD. DESIGN AND SETTING: The Rotterdam Study, a large population-based, prospective cohort study. PARTICIPANTS AND MAIN OUTCOME MEASURES: Participants with thyroid function measurements at baseline and NAFLD data (ie, at baseline fatty liver index/at follow-up ultrasound) were eligible. Transient elastography was performed to assess the presence of fibrosis in patients with NAFLD, using the liver stiffness measurements more than or equal to 8 kPa as cutoff for clinically relevant fibrosis. The association between thyroid parameters and incident NAFLD was explored by using logistic regression models. RESULTS: A total of 9419 participants (mean age, 64.75 y) were included. The median follow-up time was 10.04 years (interquartile range, 5.70-10.88 y). After adjusting for age, sex, cohort, follow-up time, use of hypolipidemic drugs, and cardiovascular risk factors, higher free T4 levels were associated with a decreased risk of NAFLD (odds ratio, 0.42; 95% confidence interval [CI], 0.28-0.63). In line, higher TSH levels were associated with an increased risk of having clinically relevant fibrosis in NAFLD (odds ratio, 1.49; CI, 1.04-2.15). Compared with euthyroidism, hypothyroidism was associated with a 1.24-fold higher NAFLD risk (CI, 1.01-1.53). Moreover, NAFLD risk decreased gradually from hypothyroidism to hyperthyroidism (P for trend = .003). CONCLUSION: Lower thyroid function is associated with an increased NAFLD risk. These findings may lead to new avenues regarding NAFLD prevention and treatment.
Authors: Paul Manka; Lars Bechmann; Jan Best; Svenja Sydor; Lee C Claridge; Jason D Coombes; Ali Canbay; Lars Moeller; Guido Gerken; Heiner Wedemeyer; Wing-Kin Syn Journal: Dig Dis Sci Date: 2019-06-03 Impact factor: 3.199
Authors: M Arfan Ikram; Guy G O Brusselle; Sarwa Darwish Murad; Cornelia M van Duijn; Oscar H Franco; André Goedegebure; Caroline C W Klaver; Tamar E C Nijsten; Robin P Peeters; Bruno H Stricker; Henning Tiemeier; André G Uitterlinden; Meike W Vernooij; Albert Hofman Journal: Eur J Epidemiol Date: 2017-10-24 Impact factor: 8.082
Authors: Arjola Bano; Klodian Dhana; Layal Chaker; Maryam Kavousi; M Arfan Ikram; Francesco U S Mattace-Raso; Robin P Peeters; Oscar H Franco Journal: JAMA Intern Med Date: 2017-11-01 Impact factor: 21.873
Authors: Carolina Castro Porto Silva Janovsky; Fernando H Cesena; Viviane Arevalo Tabone Valente; Raquel Dilguerian de Oliveira Conceição; Raul D Santos; Márcio Sommer Bittencourt Journal: Eur Thyroid J Date: 2018-08-29