Jaruvongvanich Veeravich, Sanguankeo Anawin, Upala Sikarin
Department of Internal Medicine, University of Hawaii, Honolulu, HI, USA.
Department of Medicine, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
Eur Thyroid J. 2017 Jul;6(4):208-215. doi: 10.1159/000454920. Epub 2017 Jan 21.
Whether hypothyroidism is related to nonalcoholic fatty liver disease (NAFLD) is unclear. Thyroid dysfunction is closely related with components of metabolic syndrome. Given the hepatic manifestation of metabolic syndrome, several studies have investigated the association between NAFLD and thyroid dysfunction and have demonstrated inconsistent results. Thus, we conducted a systematic review and meta-analysis to better characterize the association between NAFLD and thyroid dysfunction.
MEDLINE and Embase were searched through July 2016. The primary outcome was the association between NAFLD and subclinical, overt, and overall hypothyroidism. The secondary outcome was the difference in thyroid hormone levels (free triiodothyronine [FT], free thyroxine [FT], or thyroid-stimulating hormone [TSH]) between NAFLD patients and non-NAFLD controls. Pooled odds ratios (OR) and 95% CI were calculated using a random-effects model. All continuous data are summarized as the mean difference along with 95% CI.
Data were extracted from 14 studies involving 7,191 NAFLD patients and 30,003 controls. NAFLD was not associated with subclinical, overt, or overall hypothyroidism compared with non-NAFLD controls. Patients who had NAFLD did not show a significant difference in FT, FT, or TSH compared with non-NAFLD controls.
Our meta-analysis demonstrates no significant association between NAFLD and subclinical, overt, or overall hypothyroidism, and we also found no significant difference in thyroid hormone levels between participants with and without NAFLD.
甲状腺功能减退症是否与非酒精性脂肪性肝病（NAFLD）相关尚不清楚。甲状腺功能障碍与代谢综合征的各组分密切相关。鉴于代谢综合征的肝脏表现，多项研究调查了NAFLD与甲状腺功能障碍之间的关联，结果并不一致。因此，我们进行了一项系统评价和荟萃分析，以更好地描述NAFLD与甲状腺功能障碍之间的关联。
检索MEDLINE和Embase至2016年7月。主要结局是NAFLD与亚临床、显性及总体甲状腺功能减退症之间的关联。次要结局是NAFLD患者与非NAFLD对照之间甲状腺激素水平（游离三碘甲状腺原氨酸[FT]、游离甲状腺素[FT]或促甲状腺激素[TSH]）的差异。采用随机效应模型计算合并比值比（OR）和95%可信区间（CI）。所有连续数据汇总为平均差及95%CI。
从14项研究中提取数据，涉及7191例NAFLD患者和30003例对照。与非NAFLD对照相比，NAFLD与亚临床、显性或总体甲状腺功能减退症无关。NAFLD患者与非NAFLD对照相比，FT、FT或TSH无显著差异。
我们的荟萃分析表明，NAFLD与亚临床、显性或总体甲状腺功能减退症之间无显著关联，且我们还发现有NAFLD和无NAFLD参与者之间甲状腺激素水平无显著差异。
