title: Thyroid function is associated with non-alcoholic fatty liver disease in chronic hepatitis B-infected subjects.
abstract: OBJECTIVE
  Associations between thyroid function and non-alcoholic fatty liver disease (NAFLD) are unknown in chronic hepatitis B (CHB)-infected patients. Thus, the aim of the study was to investigate the prevalence of thyroid dysfunction and its relationship with NAFLD in CHB.
  
  
  METHODS
  Consecutive naive CHB infected patients that had undergone liver biopsy and serum thyroid function tests between January 2007 and December 2011 were retrospective analyzed. NAFLD was diagnosed as at least 5% biopsy-proven hepatic steatosis without significant alcohol consumption.
  
  
  RESULTS
  A total of 1154 non-alcoholics with CHB were included, 270 (23.39%) patients were found to have NAFLD, most of them (88.5%) with mild steatosis. The prevalence of hyperthyroidism and hypothyroidism (including subclinical and overt) was 1.56% and 1.64%, respectively, both with similar rates in patients with and without NAFLD (1.85% vs 1.47%, 1.48% vs 1.69%, respectively, both P > 0.05). The serum thyroid-stimulating hormone (TSH) level in NAFLD patients was significantly higher than that in patients without NAFLD (2.22 ± 2.13 vs 1.61 ± 1.20 mIU/L, P < 0.05). After adjustment for age and gender, the elevated TSH level was associated with increased odds of having steatosis (odds ratio1.54, 95% confidence interval 1.049-2.271) instead of viral factors and hepatic inflammation and fibrosis.
  
  
  CONCLUSIONS
  Thyroid dysfunction is not common in CHB-infected patients, and the prevalence of hypothyroidism in CHB individuals with or without NAFLD is similar. However, increased serum TSH concentration at the normal range is a significant predictor of hepatic steatosis in patients with CHB.
authors.affiliation: Department of Gastroenterology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Children's Digestion and Nutrition, Shanghai, China.
authors.forename: Wen-Jin
authors.initials: WJ
authors.lastname: Ding
authors.affiliation: Department of Endocrinology, The Third Affiliated Hospital of Sun Yat-Sen University, Shunde, Guangdong Province, China.
authors.forename: Man-Man
authors.initials: MM
authors.lastname: Wang
authors.affiliation: Department of Infectious Disease, Shunde First People's Hospital Affiliated to Southern Medical University, Shunde, Guangdong Province, China.
authors.forename: Gong-Sui
authors.initials: GS
authors.lastname: Wang
authors.affiliation: Department of Gastroenterology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Children's Digestion and Nutrition, Shanghai, China.
authors.forename: Fen
authors.initials: F
authors.lastname: Shen
authors.affiliation: Department of Gastroenterology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Children's Digestion and Nutrition, Shanghai, China.
authors.forename: Jian-Jun
authors.initials: JJ
authors.lastname: Qin
authors.affiliation: Department of Gastroenterology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Children's Digestion and Nutrition, Shanghai, China.
authors.forename: Jian-Gao
authors.initials: JG
authors.lastname: Fan
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D005234:Fatty Liver / Q000175:diagnosis / Q000209:etiology; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications*; D006801:Humans; D006980:Hyperthyroidism / Q000453:epidemiology* / Q000209:etiology*; D007037:Hypothyroidism / Q000453:epidemiology* / Q000209:etiology*; D008297:Male; D065626:Non-alcoholic Fatty Liver Disease / Q000175:diagnosis / Q000209:etiology*; D011237:Predictive Value of Tests; D015995:Prevalence; D012189:Retrospective Studies; D013972:Thyrotropin / Q000097:blood
chemical_list: D015415:Biomarkers; D013972:Thyrotropin
keywords: hepatic steatosis; hepatitis B virus; thyroid function