Subclinical and clinical hypothyroidism and non-alcoholic fatty liver disease: a cross-sectional study of a random population sample aged 18 to 65 years.
BACKGROUND
Non-alcoholic fatty liver disease (NAFLD) is one of the most common disorders of the liver worldwide. Recently, a correlation between thyroid dysfunction and NAFLD has been discussed. Objective of the present study was to investigate the association between thyroid dysfunction and hepatic steatosis.


METHODS
Data from 2,445 subjects (51.7% females) aged 18 to 65 years participating in a population-based cross-sectional study were assessed based on a standardized questionnaire and documentation of physical, biochemical and ultrasonographic findings. After application of exclusion criteria, a total of 1,276 subjects were included in the study collective. The influence of potential factors on the development of hepatic steatosis was assessed using multivariate logistic regression.


RESULTS
The prevalence of hepatic steatosis in the study collective was 27.4% (n = 349). The serum thyroxin (TT4) concentration in subjects with hepatic steatosis was reduced (p =0.0004). Adjusting for age, or BMI, there was an increased prevalence of hepatic steatosis in subjects with reduced TT4 concentrations (p = 0.0143; p = < .0001).


CONCLUSIONS
The findings of the present study confirm an association between both subclinical and clinical hypothyroidism and hepatic steatosis.
Department of Internal Medicine I, Center for Internal Medicine, University Medical Center Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany. ulla.ludwig@uniklinik-ulm.de.
Ulla
U
Ludwig
Department of Internal Medicine I, Center for Internal Medicine, University Medical Center Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany. Daniela.holzner@uni-ulm.de.
Daniela
D
Holzner
Department of Pediatrics and Adolescent Medicine, University Medical Center Ulm, Eythstr. 24, 89075, Ulm, Germany.
Christian
C
Denzer
Department of Internal Medicine I, Center for Internal Medicine, University Medical Center Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany. greinertartur@gmx.net.
Artur
A
Greinert
Department of Internal Medicine I, Center for Internal Medicine, University Medical Center Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany. mark.haenle@uniklinik-ulm.de.
Mark Martin
MM
Haenle
Department of Internal Medicine I, Center for Internal Medicine, University Medical Center Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany. suemeyra.oezturk@uniklinik-ulm.de.
Suemeyra
S
Oeztuerk
Department of Internal Medicine II, Center for Internal Medicine, University Medical Center Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany. wolfgang.koenig@uniklinik-ulm.de.|Deutsches Herzzentrum München, Technische Universität München, Munich, Germany. wolfgang.koenig@uniklinik-ulm.de.|DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany. wolfgang.koenig@uniklinik-ulm.de.
Wolfgang
W
Koenig
Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore. Bernhard.boehm@ntu.edu.sg.|Imperial College London, London, UK. Bernhard.boehm@ntu.edu.sg.
Bernhard Otto
BO
Boehm
Louis Stokes Cleveland Department of Veterans Affairs Medical Center, 10701 East Boulevard, Cleveland, OH, 44106, USA. richard.mason2@va.gov.
Richard Andrew
RA
Mason
Department of Internal Medicine I, Center for Internal Medicine, University Medical Center Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany. wolfgang.kratzer@uniklinik-ulm.de.
Wolfgang
W
Kratzer
Department of Diagnostic and Interventional Radiology, University Medical Center Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany. Tilmann.graeter@uniklinik-ulm.de.
Tilmann
T
Graeter
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007037:Hypothyroidism / Q000097:blood / Q000453:epidemiology*; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology; D008875:Middle Aged; D015999:Multivariate Analysis; D065626:Non-alcoholic Fatty Liver Disease / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology*; D050177:Overweight / Q000453:epidemiology; D015995:Prevalence; D012720:Severity of Illness Index; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood; D014284:Triiodothyronine / Q000097:blood; D014463:Ultrasonography; D049629:Waist-Hip Ratio; D055815:Young Adult
D014284:Triiodothyronine; D013972:Thyrotropin; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D013974:Thyroxine