Thyroid function and Liver Fibrosis: Study unveils Link Between Liver Fibrosis and Hypothyroid Spectrum

A new study conducted at the Huazhong
University of Science and Technology (Wuhan, China) found that liver fibrosis
is highly prevalent in hypothyroid individuals and across the hypothyroid
spectrum, as per the results published in the Journal of Gastroenterology.

Metabolic dysfunction n-associated
steatotic liver disease (MASLD) or non-alcoholic fatty liver disease (NAFLD) is
a common disease affecting globally. Studies have shown that hypothyroidism,
even in the low-normal level, can progress the severity of MASLD. Even though
previous literature assessed the prevalence of MASLD in hypothyroidism, there
is uncertainty about the incidence of liver fibrosis. Some studies evaluated
the liver fibrotic burden using serum markers, but there are no studies that
evaluated liver fibrosis using vibration-controlled transient elastography
(VCTE) in hypothyroid individuals. Hence, researchers conducted a study to
evaluate the prevalence of liver fibrotic burden across the spectrum of
hypothyroidism assessed by VCTE.

Also Read: Liver Fibrosis Scores closely Linked to Elevated Heart Failure Risk: Study

A cross-sectional analysis of
about 30,091 individuals who attended a Health management Centre between 2019
and 2021 was carried out. Based on thyroid levels, participants were
categorized as having strict-normal thyroid function, low-normal thyroid
function, subclinical hypothyroidism, and overt hypothyroidism. Using
vibration-controlled transient elastography (VCTE), liver fibrosis was assessed.
Significant and advanced fibrosis was defined as liver stiffness measurements
in VCTE of 8.1–9.6 and 9.7–13.5 kPa, respectively.

Findings:

  • Liver fibrosis was found to be more common in
    the low-normal thyroid function group, subclinical hypothyroidism group, and
    overt hypothyroidism group than in the strict-normal thyroid function group.
  • The fibrosis ranged from mild fibrosis,
    significant fibrosis, advanced fibrosis, and cirrhosis.
  • Liver fibrosis was similar between the low-normal
    thyroid function group and the subclinical hypothyroidism group.
  • The highest liver fibrosis was seen in the overt
    hypothyroidism group.
  • A significant association was found between both
    significant and advanced liver fibrosis and low-normal thyroid function,
    subclinical hypothyroidism, and overt hypothyroidism in both men and women.
Also Read: Bone Mineral Density Declines More Rapidly in Adults With Cystic Fibrosis, finds study

Thus, the study concluded that
Liver fibrotic burden is highly prevalent in subjects with overt
hypothyroidism. The pattern of fibrosis was also increased across the spectrum
of hypothyroidism even within the low normal thyroid function. Hence,
researchers suggested that screening for liver fibrosis should be carried out
in patients with hypothyroidism to rule out fibrosis.

Further reading: Du, T., Huang,
Y., Lv, Y. et al. Liver fibrotic burden across the spectrum of
hypothyroidism. J Gastroenterol (2024).
https://doi.org/10.1007/s00535-024-02184-x

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