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Mantovani A, Csermely A, Bilson J, Borella N, Enrico S, Pecoraro B, Shtembari E, Morandin R, Polyzos SA, Valenti L, Tilg H, Byrne CD, Targher G. Association between primary hypothyroidism and metabolic dysfunction-associated steatotic liver disease: an updated meta-analysis. Gut 2024; 73:1554-1561. [PMID: 38782564 DOI: 10.1136/gutjnl-2024-332491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Accepted: 05/15/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVE Epidemiological studies have reported an association between primary hypothyroidism and metabolic dysfunction-associated steatotic liver disease (MASLD). However, the magnitude of the risk and whether this risk changes with the severity of MASLD remains uncertain. We performed a meta-analysis of observational studies to quantify the magnitude of the association between primary hypothyroidism and the risk of MASLD. DESIGN We systematically searched PubMed, Scopus and Web of Science from database inception to 31 January 2024, using predefined keywords to identify observational studies in which MASLD was diagnosed by liver biopsy, imaging or International Classification of Diseases codes. A meta-analysis was performed using random-effects modelling. RESULTS We identified 24 cross-sectional and 4 longitudinal studies with aggregate data on ~76.5 million individuals. Primary hypothyroidism (defined as levothyroxine replacement treatment, subclinical hypothyroidism or overt hypothyroidism) was associated with an increased risk of prevalent MASLD (n=24 studies; random-effects OR 1.43, 95% CI 1.23 to 1.66; I2=89%). Hypothyroidism was also associated with a substantially higher risk of metabolic dysfunction-associated steatohepatitis or advanced fibrosis (n=5 studies; random-effects OR 2.84, 95% CI 2.07 to 3.90; I2=0%). Meta-analysis of data from four longitudinal studies showed that there was a marginally non-significant association between hypothyroidism and risk of developing MASLD over a median 4.5-year follow-up (random-effects HR 1.39, 95% CI 0.98 to 1.97; I2=85%). Sensitivity analyses did not modify these findings. The funnel plot did not reveal any significant publication bias. CONCLUSION This large and updated meta-analysis provides evidence that primary hypothyroidism is significantly associated with both an increased presence of and histological severity of MASLD.
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Affiliation(s)
- Alessandro Mantovani
- Endocrinology and Metabolism, University of Verona Faculty of Medicine and Surgery, Verona, Italy
| | - Alessandro Csermely
- Endocrinology and Metabolism, University of Verona Faculty of Medicine and Surgery, Verona, Italy
| | - Josh Bilson
- Southampton General Hospital, Southampton, UK
| | - Niccolò Borella
- Endocrinology and Metabolism, University of Verona Faculty of Medicine and Surgery, Verona, Italy
| | - Scoccia Enrico
- Endocrinology and Metabolism, University of Verona Faculty of Medicine and Surgery, Verona, Italy
| | - Barbara Pecoraro
- Endocrinology and Metabolism, University of Verona Faculty of Medicine and Surgery, Verona, Italy
| | - Emigela Shtembari
- Endocrinology and Metabolism, University of Verona Faculty of Medicine and Surgery, Verona, Italy
| | - Riccardo Morandin
- Endocrinology and Metabolism, University of Verona Faculty of Medicine and Surgery, Verona, Italy
| | - Stergios A Polyzos
- First Laboratory of Pharmacology, School of Medicine, Aristotle University of Thessaloniki Faculty of Health Sciences, Thessaloniki, Greece
| | - Luca Valenti
- Department of Transfusion Medicine, Precision Medicine Lab, Biological Resource Center, IRCCS Cà Granda Ospedale Maggiore Policlinico, milano, Italy
| | - Herbert Tilg
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology & Metabolism, Medizinische Universitat Innsbruck, Innsbruck, Austria
| | | | - Giovanni Targher
- Metabolic Diseases Research Unit, IRCCS Sacro Cuore - Don Calabria Hospital, Negrar di Valpolicella (VR), Italy
- Department of Medicine, University of Verona Faculty of Medicine and Surgery, Verona, Italy
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Zhao J, Liu L, Cao YY, Gao X, Targher G, Byrne CD, Sun DQ, Zheng MH. MAFLD as part of systemic metabolic dysregulation. Hepatol Int 2024:10.1007/s12072-024-10660-y. [PMID: 38594474 DOI: 10.1007/s12072-024-10660-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 02/11/2024] [Indexed: 04/11/2024]
Abstract
Nonalcoholic fatty liver disease (NAFLD) is one of the most common chronic liver diseases worldwide. In recent years, a new terminology and definition of metabolic dysfunction-associated fatty liver disease (MAFLD) has been proposed. Compared to the NAFLD definition, MAFLD better emphasizes the pathogenic role of metabolic dysfunction in the development and progression of this highly prevalent condition. Metabolic disorders, including overweight/obesity, type 2 diabetes mellitus (T2DM), atherogenic dyslipidemia and hypertension, are often associated with systemic organ dysfunctions, thereby suggesting that multiple organ damage can occur in MAFLD. Substantial epidemiological evidence indicates that MAFLD is not only associated with an increased risk of liver-related complications, but also increases the risk of developing several extra-hepatic diseases, including new-onset T2DM, adverse cardiovascular and renal outcomes, and some common endocrine diseases. We have summarized the current literature on the adverse effect of MAFLD on the development of multiple extrahepatic (cardiometabolic and endocrine) complications and examined the role of different metabolic pathways and organ systems in the progression of MAFLD, thus providing new insights into the role of MAFLD as a multisystem metabolic disorder. Our narrative review aimed to provide insights into potential mechanisms underlying the known associations between MAFLD and extrahepatic diseases, as part of MAFLD as a multisystem disease, in order to help focus areas for future drug development targeting not only liver disease but also the risk of extrahepatic complications.
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Affiliation(s)
- Jing Zhao
- Urologic Nephrology Center, Jiangnan University Medical Center, Wuxi, China
- Affiliated Wuxi Clinical College of Nantong University, Wuxi, China
- Wuxi No. 2 People's Hospital, Wuxi, China
| | - Lu Liu
- Urologic Nephrology Center, Jiangnan University Medical Center, Wuxi, China
- Affiliated Wuxi Clinical College of Nantong University, Wuxi, China
- Wuxi No. 2 People's Hospital, Wuxi, China
| | - Ying-Ying Cao
- MAFLD Research Center, Department of Hepatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- Key Laboratory of Diagnosis and Treatment for the Development of Chronic Liver Disease in Zhejiang Province, Wenzhou, Zhejiang, China
| | - Xin Gao
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Giovanni Targher
- Department of Medicine, University of Verona, Verona, Italy
- Metabolic Diseases Research Unit, IRCCS Sacro Cuore-Don Calabria Hospital, Negrar di Valpolicella, Italy
| | - Christopher D Byrne
- Southampton National Institute for Health and Care Research Biomedical Research Centre, University Hospital Southampton, and University of Southampton, Southampton General Hospital, Southampton, UK
| | - Dan-Qin Sun
- Urologic Nephrology Center, Jiangnan University Medical Center, Wuxi, China.
- Affiliated Wuxi Clinical College of Nantong University, Wuxi, China.
- Wuxi No. 2 People's Hospital, Wuxi, China.
| | - Ming-Hua Zheng
- MAFLD Research Center, Department of Hepatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
- Key Laboratory of Diagnosis and Treatment for the Development of Chronic Liver Disease in Zhejiang Province, Wenzhou, Zhejiang, China.
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Calcaterra V, Degrassi I, Taranto S, Porro C, Bianchi A, L’assainato S, Silvestro GS, Quatrale A, Zuccotti G. Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD) and Thyroid Function in Childhood Obesity: A Vicious Circle? CHILDREN (BASEL, SWITZERLAND) 2024; 11:244. [PMID: 38397356 PMCID: PMC10887660 DOI: 10.3390/children11020244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 02/10/2024] [Accepted: 02/14/2024] [Indexed: 02/25/2024]
Abstract
Metabolic dysfunction-associated fatty liver disease (MAFLD) is a multisystem disorder characterized by the presence of fatty liver degeneration associated with excess adiposity or prediabetes/type 2 diabetes or metabolic dysregulation. An intricate relationship between the liver and thyroid has been reported in both health and disease. Simultaneously, there is a strong correlation between obesity and both MAFLD and thyroid dysfunction. In this narrative review, we highlighted the relationship between MAFLD and thyroid function in children and adolescents with obesity in order to explore how thyroid hormones (THs) act as predisposing factors in the onset, progression, and sustainability of MAFLD. THs are integral to the intricate balance of metabolic activities, ensuring energy homeostasis, and are indispensable for growth and development. Regarding liver homeostasis, THs have been suggested to interact with liver lipid homeostasis through a series of processes, including stimulating the entry of free fatty acids into the liver for esterification into triglycerides and increasing mitochondrial β-oxidation of fatty acids to impact hepatic lipid accumulation. The literature supports a correlation between MAFLD and obesity, THs and obesity, and MAFLD and THs; however, results in the pediatric population are very limited. Even though the underlying pathogenic mechanism involved in the relationship between MAFLD and thyroid function remains not fully elucidated, the role of THs as predisposing factors of MAFLD could be postulated. A potential vicious circle among these three conditions cannot be excluded. Identifying novel elements that may contribute to MAFLD could offer a practical approach to assessing children at risk of developing the condition.
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Affiliation(s)
- Valeria Calcaterra
- Pediatric and Adolescent Unit, Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy; (I.D.); (S.T.); (C.P.); (A.B.); (S.L.); (G.S.S.); (A.Q.); (G.Z.)
| | - Irene Degrassi
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy; (I.D.); (S.T.); (C.P.); (A.B.); (S.L.); (G.S.S.); (A.Q.); (G.Z.)
| | - Silvia Taranto
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy; (I.D.); (S.T.); (C.P.); (A.B.); (S.L.); (G.S.S.); (A.Q.); (G.Z.)
| | - Cecilia Porro
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy; (I.D.); (S.T.); (C.P.); (A.B.); (S.L.); (G.S.S.); (A.Q.); (G.Z.)
| | - Alice Bianchi
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy; (I.D.); (S.T.); (C.P.); (A.B.); (S.L.); (G.S.S.); (A.Q.); (G.Z.)
| | - Sara L’assainato
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy; (I.D.); (S.T.); (C.P.); (A.B.); (S.L.); (G.S.S.); (A.Q.); (G.Z.)
| | - Giustino Simone Silvestro
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy; (I.D.); (S.T.); (C.P.); (A.B.); (S.L.); (G.S.S.); (A.Q.); (G.Z.)
| | - Antonia Quatrale
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy; (I.D.); (S.T.); (C.P.); (A.B.); (S.L.); (G.S.S.); (A.Q.); (G.Z.)
| | - Gianvincenzo Zuccotti
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy; (I.D.); (S.T.); (C.P.); (A.B.); (S.L.); (G.S.S.); (A.Q.); (G.Z.)
- Department of Biomedical and Clinical Science “L. Sacco”, University of Milan, 20157 Milan, Italy
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Trinks N, Roden M. Response Letter to: Association of thyroid function with nonalcoholic fatty liver disease in recent-onset diabetes. Liver Int 2024; 44:630-631. [PMID: 38014524 DOI: 10.1111/liv.15808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 11/21/2023] [Indexed: 11/29/2023]
Affiliation(s)
- Nina Trinks
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Institute for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany
- German Center for Diabetes Research (DZD e.V.), München-Neuherberg, Germany
| | - Michael Roden
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Institute for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany
- German Center for Diabetes Research (DZD e.V.), München-Neuherberg, Germany
- Department of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine, Düsseldorf, Germany
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Wang S, Xia D, Fan H, Liu Z, Chen R, Suo C, Zhang T. Low thyroid function is associated with metabolic dysfunction-associated steatotic liver disease. JGH Open 2024; 8:e13038. [PMID: 38405186 PMCID: PMC10885173 DOI: 10.1002/jgh3.13038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 01/06/2024] [Accepted: 01/28/2024] [Indexed: 02/27/2024]
Abstract
Background and Aim Metabolic dysfunction-associated steatotic liver disease (MASLD) is recently introduced to better highlight the pathogenic significance of cardiometabolic dysfunction, as compared with non-alcoholic fatty liver disease. This study aimed to investigate the association between low thyroid function and MASLD in the new context. Methods We recruited 2901 participants for our retrospective cohort study from 2016 to 2021. Participants were divided into strict-normal thyroid function and low thyroid function groups (low-normal thyroid function, subclinical hypothyroidism) based on initial thyroid stimulating hormone (TSH) levels, respectively. Cox regression models were used to estimate the hazard ratios (HRs) and 95% CI. Results During a median follow-up of 15.6 months, 165 (8.9%) strict-normal thyroid function subjects and 141 (13.4%) low thyroid function subjects developed MASLD; this result was statistically relevant (P < 0.05). Univariate regression analysis showed that low thyroid function and subclinical hypothyroidism were statistically significantly associated with MASLD (low thyroid function: HR1.53; 95% CI 1.22-1.92; subclinical hypothyroidism: HR1.95; 95% CI 1.47-2.60). Conclusions MASLD is associated with low thyroid function and the relationship between MASLD and low thyroid function is independent.
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Affiliation(s)
- Shuo Wang
- Department of Epidemiology, School of Public HealthFudan UniversityShanghaiChina
| | - Ding Xia
- Department of Epidemiology, School of Public HealthFudan UniversityShanghaiChina
- Lifecycle Health Management Center, Ruijin HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Hong Fan
- Department of Epidemiology, School of Public HealthFudan UniversityShanghaiChina
| | - Zhenqiu Liu
- Fudan University Taizhou Institute of Health SciencesTaizhouChina
- State Key Laboratory of Genetic Engineering, Human Phenome Institute, School of Life SciencesFudan UniversityShanghaiChina
| | - Ruilin Chen
- Department of Epidemiology, School of Public HealthFudan UniversityShanghaiChina
| | - Chen Suo
- Department of Epidemiology, School of Public HealthFudan UniversityShanghaiChina
- Fudan University Taizhou Institute of Health SciencesTaizhouChina
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public HealthFudan UniversityShanghaiChina
| | - Tiejun Zhang
- Department of Epidemiology, School of Public HealthFudan UniversityShanghaiChina
- Fudan University Taizhou Institute of Health SciencesTaizhouChina
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public HealthFudan UniversityShanghaiChina
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6
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Li Z, Wu X, Chen Z, Wei X, Chen W. Association between low-normal thyroid function and advanced liver fibrosis in metabolic dysfunction-associated fatty liver disease patients: a retrospective cohort study. Gastroenterol Rep (Oxf) 2024; 12:goad076. [PMID: 38264763 PMCID: PMC10805339 DOI: 10.1093/gastro/goad076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 11/09/2023] [Accepted: 12/10/2023] [Indexed: 01/25/2024] Open
Abstract
Background Recent studies have found that thyroid function may be associated with the occurrence and development of advanced liver fibrosis in patients with metabolic dysfunction-associated fatty liver disease (MAFLD). However, the majority of such research has consisted of cross-sectional studies. This retrospective cohort study aimed to investigate the effect of low-normal thyroid function on advanced liver fibrosis in MAFLD patients over a 5-year period. Methods This retrospective cohort study enrolled 825 outpatients and inpatients with MAFLD who attended the Third Affiliated Hospital of Sun Yat-sen University (Guangzhou, China) between January 2011 and December 2018. Based on plasma thyroid hormone and thyroid-stimulating hormone levels, these patients were divided into two groups, namely a low-normal thyroid function group and a strict-normal thyroid function group. The fibrosis-4 score was used to assess advanced liver fibrosis. A chi-square test was conducted to compare the occurrence of advanced fibrosis between the groups. Results Among the 825 MAFLD patients, 117 and 708 were defined as having low-normal thyroid function and strict-normal thyroid function, respectively. Follow-up data were available for 767 patients (93.0%) during a 5-year period. Eight (7.5%) MAFLD patients with low-normal thyroid function and 26 (3.9%) with strict-normal thyroid function developed advanced liver fibrosis and the cumulative incidence was not significantly different (P = 0.163). Stratification analysis showed that the lean MAFLD patients (body mass index ≤ 23 kg/m2) with low-normal thyroid function had a higher risk of advanced liver fibrosis than the lean MAFLD patients with strict-normal thyroid function (P < 0.05). Conclusion Low-normal thyroid function is associated with advanced liver fibrosis among lean MAFLD patients.
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Affiliation(s)
- Zixuan Li
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, P. R. China
| | - Xiaoying Wu
- Department of Gastroenterology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, P. R. China
| | - Zebin Chen
- Center of Hepato-Pancreatico-Biliary Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, P. R. China
| | - Xiuqing Wei
- Department of Gastroenterology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, P. R. China
| | - Weiqing Chen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, P. R. China
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Liu X, Liu J, Zhang T, Wang Q, Zhang H. Complex relationship between gut microbiota and thyroid dysfunction: a bidirectional two-sample Mendelian randomization study. Front Endocrinol (Lausanne) 2023; 14:1267383. [PMID: 38027113 PMCID: PMC10667917 DOI: 10.3389/fendo.2023.1267383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023] Open
Abstract
Background Many studies have reported the link between gut microbiota and thyroid dysfunction. However, the causal effect of gut microbiota on thyroid dysfunction and the changes in gut microbiota after the onset of thyroid dysfunction are not clear. Methods A two-sample Mendelian randomization (MR) study was used to explore the complex relationship between gut microbiota and thyroid dysfunction. Data on 211 bacterial taxa were obtained from the MiBioGen consortium, and data on thyroid dysfunction, including hypothyroidism, thyroid-stimulating hormone alteration, thyroxine deficiency, and thyroid peroxidase antibodies positivity, were derived from several databases. Inverse variance weighting (IVW), weighted median, MR-Egger, weighted mode, and simple mode were applied to assess the causal effects of gut microbiota on thyroid dysfunction. Comprehensive sensitivity analyses were followed to validate the robustness of the results. Finally, a reverse MR study was conducted to explore the alteration of gut microbiota after hypothyroidism onset. Results Our bidirectional two-sample MR study revealed that the genera Intestinimonas, Eubacterium brachy group, Ruminiclostridium5, and Ruminococcaceae UCG004 were the risk factors for decreased thyroid function, whereas the genera Bifidobacterium and Lachnospiraceae UCG008 and phyla Actinobacteria and Verrucomicrobia were protective. The abundance of eight bacterial taxa varied after the onset of hypothyroidism. Sensitivity analysis showed that no heterogeneity or pleiotropy existed in the results of this study. Conclusion This novel MR study systematically demonstrated the complex relationship between gut microbiota and thyroid dysfunction, which supports the selection of more targeted probiotics to maintain thyroid-gut axis homeostasis and thus to prevent, control, and reverse the development of thyroid dysfunction.
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Affiliation(s)
| | | | | | - Qian Wang
- Department of Ultrasound, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Huawei Zhang
- Department of Ultrasound, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
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Liu H, Xing Y, Nie Q, Li Z, Meng C, Ma H. Association Between Sensitivity to Thyroid Hormones and Metabolic Dysfunction-Associated Fatty Liver Disease in Euthyroid Subjects: A Cross-Sectional Study. Diabetes Metab Syndr Obes 2023; 16:2153-2163. [PMID: 37492438 PMCID: PMC10363669 DOI: 10.2147/dmso.s420872] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 07/03/2023] [Indexed: 07/27/2023] Open
Abstract
Objective Thyroid hormones (THs) exert instrumental effects in regulating lipids metabolism. Whereas, research investigating the relationship between sensitivity indices to THs and metabolic dysfunction-associated fatty liver disease (MAFLD) have contradicted this. This study was designed to approach the correlation between sensitivity indices to THs and MAFLD in euthyroid subjects. Methods An overall sample of 6356 euthyroid participants were enrolled in a Chinese hospital. Free triiodothyronine to free thyroxine ratio (FT3/FT4), thyrotropin triiodothyronine resistance index (TT3RI), thyrotropin thyroxine resistance index (TT4RI), thyroid stimulating hormone index (TSHI) and thyroid feedback quantile-based indices (TFQIFT3 and TFQIFT4) were collected as sensitivity indicators to THs. Participants were split into two groups based on whether they suffered with MAFLD or not. And participants were categorized into quartiles based on sensitivity indicators to THs. The effects of sensitivity indices to THs on MAFLD were analyzed using regression analysis. Bootstrap was performed to assess the mediation effect of triglyceride glucose (TyG) index on the relationship between sensitivity parameters to THs and MAFLD. Results The incidence of MAFLD in euthyroid subjects was 34.47%. As FT3/FT4, TT3RI and TFQIFT3 levels rose, so did the MAFLD prevalence. After adjustment for confounders, logistic regression analyses indicated that the high-level FT3/FT4 and TFQIFT3 still remained risk factors for MAFLD. The relevance of FT3/FT4 and MAFLD was stronger among those whose age ≤ 40 years and had non-visceral obesity. And the interrelation between TFQIFT3 and MAFLD was stronger in subjects whose age ≤ 40 years. Mediation analyses suggested that TyG index had a noteworthy indirect impact on the relationship between FT3/FT4, TFQIFT3 and MAFLD. Conclusion Increased FT3/FT4 and TFQIFT3 were significantly related to MAFLD prevalence in populations with normal thyroid function. TyG index partly mediated the relevance between FT3/FT4, TFQIFT3 and MAFLD.
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Affiliation(s)
- Huanxin Liu
- Health Examination Center, Hebei General Hospital, Shijiazhuang, Hebei, 050051, People’s Republic of China
| | - Yuling Xing
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei, 050051, People’s Republic of China
| | - Qian Nie
- Health Examination Center, Hebei General Hospital, Shijiazhuang, Hebei, 050051, People’s Republic of China
| | - Zhong Li
- Department of General Surgery, Shijiazhuang People’s Hospital, Shijiazhuang, 050011, People’s Republic of China
| | - Cuiqiao Meng
- Health Examination Center, Hebei General Hospital, Shijiazhuang, Hebei, 050051, People’s Republic of China
| | - Huijuan Ma
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei, 050051, People’s Republic of China
- Key Laboratory of Metabolic Disease in Hebei Province, Hebei General Hospital, Shijiazhuang, Hebei, 050051, People’s Republic of China
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Tsutsumi T, Nakano D, Hashida R, Sano T, Kawaguchi M, Amano K, Kawaguchi T. The Inter-Organ Crosstalk Reveals an Inevitable Link between MAFLD and Extrahepatic Diseases. Nutrients 2023; 15:nu15051123. [PMID: 36904122 PMCID: PMC10005526 DOI: 10.3390/nu15051123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 02/19/2023] [Accepted: 02/21/2023] [Indexed: 02/25/2023] Open
Abstract
Fatty liver is known to be associated with extra-hepatic diseases including atherosclerotic cardiovascular disease and extra-hepatic cancers, which affect the prognosis and quality of life of the patients. The inter-organ crosstalk is mediated by metabolic abnormalities such as insulin resistance and visceral adiposity. Recently, metabolic dysfunction-associated fatty liver disease (MAFLD) was proposed as a new definition for fatty liver. MAFLD is characterized by the inclusion criteria of metabolic abnormality. Therefore, MAFLD is expected to identify patients at high risk of extra-hepatic complications. In this review, we focus on the relationships between MAFLD and multi-organ diseases. We also describe the pathogenic mechanisms of the inter-organ crosstalk.
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Affiliation(s)
- Tsubasa Tsutsumi
- Division of Gastroenterology, Department of Medicine, School of Medicine, Kurume University, Kurume 830-0011, Japan
| | - Dan Nakano
- Division of Gastroenterology, Department of Medicine, School of Medicine, Kurume University, Kurume 830-0011, Japan
| | - Ryuki Hashida
- Department of Orthopedics, School of Medicine, Kurume University, Kurume 830-0011, Japan
| | - Tomoya Sano
- Division of Gastroenterology, Department of Medicine, School of Medicine, Kurume University, Kurume 830-0011, Japan
| | - Machiko Kawaguchi
- Division of Gastroenterology, Department of Medicine, School of Medicine, Kurume University, Kurume 830-0011, Japan
| | - Keisuke Amano
- Division of Gastroenterology, Department of Medicine, School of Medicine, Kurume University, Kurume 830-0011, Japan
| | - Takumi Kawaguchi
- Division of Gastroenterology, Department of Medicine, School of Medicine, Kurume University, Kurume 830-0011, Japan
- Correspondence: ; Tel.: +81-942-31-7627
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