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Relationship between impaired sensitivity to thyroid hormones and MAFLD with elevated liver enzymes in the euthyroid population

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International Journal of Diabetes in Developing Countries Aims and scope Submit manuscript

Abstract

Objective

There is a delicate interplay between thyroid hormones and thyrotropin (TSH) and metabolic homeostasis. However, the role of thyroid hormone sensitivity in metabolic health, particularly in relation to metabolic dysfunction-associated fatty liver disease (MAFLD) and associated complications such as elevated liver enzymes and free fatty acid (FFAs) has not been elucidated in euthyroid populations.

Methods

A total of 3929 euthyroid adults from the Second Affiliated Hospital, Jiangxi Medical College, Nanchang University were included in this study. Thyroid hormone sensitivity indices were calculated by thyroid feedback quantile-based index (TFQI), TSH index (TSHI) and thyrotropin thyroxine resistance index (TT4RI). Associations between thyroid hormones sensitivities and risk of MAFLD, MAFLD with elevated liver enzymes, MAFLD with elevated FFAs were assessed with logistic regression.

Results

After adjustment for multiple risk factors, adjusted odds ratio (AOR) of the fourth versus the first TFQIFT4 quartile for MAFLD, MAFLD with elevated liver enzymes, and MAFLD with elevated FFAs were 1.778 (95% CI 1.378, 2.293), 1.466 (1.105, 1.945), and 1.936 (1.479, 2.534), respectively (all p<0.001). Per 1 SD in TFQIFT4, ORs increased 2.27 (95% CI 1.74, 2.97) for MAFLD, 2.05 (1.51, 2.78) for MAFLD with elevated liver enzymes, and 2.43 (1.82, 3.24) for MAFLD with elevated FFAs. The other sensitivity to thyroid hormones indices showed similar associations for MAFLD and MAFLD with elevated liver enzymes.

Conclusions

These findings have important implications for understanding the role of thyroid hormone sensitivity in metabolic health, particularly in relation to MAFLD and associated complications such as elevated liver enzymes and FFAs. TFQIFT4, TFQIFT3, TSHI and TT4RI can be used as new indicators for predicting MAFLD and MAFLD with elevated liver enzymes.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Acknowledgments

We would like to thank the members of the Information Department of the Second Affiliated Hospital, Jiangxi Medical College, Nanchang University for providing useful data.

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Authors and Affiliations

  1. Department of Endocrinology and Metabolism, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, 1 Minde Road, Nanchang, 330006, China

    Haixia Zeng, Jianping Liu & Yuying Zhang

  2. Institute for the Study of Endocrinology and Metabolism in Jiangxi Province, Nanchang, 330006, China

    Jianping Liu

Authors
  1. Haixia Zeng
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Contributions

Haixia Zeng was responsible for the design, management, data collection, analysis, and writing of the study. Yuying Zhang was involved in the design of the study and data collection. Jianping Liu was involved in formal analysis, supervision, writing—review, and editing. All authors read and approved the final paper.

Corresponding author

Correspondence to Jianping Liu.

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Conflict of interest

The authors declare that they have no competing interests.

Statement of ethics

This retrospective cohort study was approved by the Information Management Organization of the Second Affiliated Hospital, Jiangxi Medical College, Nanchang University.

Consent of patient

Given that the study does not involve direct patient data or identifiable information, as well as enrolment of participants, the Research Ethics Committee of the Second Affiliated Hospital, Jiangxi Medical College, Nanchang University deemed the research to not require informed consent.

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Zeng, H., Liu, J. & Zhang, Y. Relationship between impaired sensitivity to thyroid hormones and MAFLD with elevated liver enzymes in the euthyroid population. Int J Diabetes Dev Ctries (2024). https://doi.org/10.1007/s13410-023-01308-y

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