Z Gastroenterol 2019; 57(01): e48
DOI: 10.1055/s-0038-1677173
3. Metabolism (incl. NAFLD)
Georg Thieme Verlag KG Stuttgart · New York

Low free triiodothyronine (fT3) is associated with advanced fibrosis in non-alcoholic steatohepatitis (NASH)

P Manka
1   Department of Gastroenterology and Hepatology, University Hospital Essen, Essen, Germany
3   Division of Gastroenterology and Hepatology, Department of Medicine, Medical University of South Carolina, Charleston (SC), USA
,
L Bechmann
2   Gastroenterology, Hepatology and Infectiology, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
,
S Sydor
2   Gastroenterology, Hepatology and Infectiology, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
,
J Best
2   Gastroenterology, Hepatology and Infectiology, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
,
A Canbay
2   Gastroenterology, Hepatology and Infectiology, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
,
G Gerken
1   Department of Gastroenterology and Hepatology, University Hospital Essen, Essen, Germany
,
WK Syn
3   Division of Gastroenterology and Hepatology, Department of Medicine, Medical University of South Carolina, Charleston (SC), USA
4   Section of Gastroenterology, Ralph H Johnson Veteran Affairs Medical Center, Charleston (SC), USA
,
H Wedemeyer
1   Department of Gastroenterology and Hepatology, University Hospital Essen, Essen, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
04 January 2019 (online)

Also available at
 
 

    Background and Aim:

    Thyroid hormone (TH) is critical for tissue-organ development, growth, differentiation, and metabolism especially in the liver. In recent studies of patients with nonalcoholic steatohepatitis (NASH) hypothyroidism and low T3 were associated with advanced steatosis and progress of disease. These findings suggest that TH function might be a regulator of NASH. Therefore, we evaluated the effect of plasma TSH/fT3/fT4 levels on the severity of surrogate markers associated with nonalcoholic fatty liver disease (NAFLD) progress.

    Methods:

    We performed a retrospective analysis of 144 NASH patients who were seen in our NASH outpatient clinic between 2015 and 2017. Each patient underwent a standard anthropometric assessment, laboratory and clinical evaluations, and elastography. Univariate analysis and multivariate linear and logistic regression analysis were used to identify factors independently associated with nonalcoholic steatohepatitis (NASH) and advanced fibrosis.

    Results:

    Low fT3 values but not TSH and T4 were associated with higher elastography values (< 7,5kPa vs. > 12,5kPa: 5 vs. 4.5 [ng/l], p < 0.01) and higher NAFLD-Fibrosis score values (NFS: <-1,455 vs. > 0.675; 5,1 vs. 4,3 [ng/l], p < 0.0001), respectively. Low T3 and and high TSH values correlated with markers of liver disease including INR, albumin, ALT, AST, bilirubin, and platelets. In multivariate analyses, low fT3 was independently associated with high NFS results (OR: 0.169, CI 0.05 – 0.54, p = 0.003) and was part of the strongest independent factors associated with high transient elastography values (OR: 0.326, CI 0.135 – 0.785, p = 0.001).

    Conclusion:

    Low normal thyroid function is predicting NASH and advanced fibrosis and could have a potential role in regulating the course of disease.


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