1Department of Gastroenterology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Children's Digestion and Nutrition, Shanghai.
2Department of Endocrinology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, China.
BACKGROUND AND AIMS:
Associations between thyroid function and nonalcoholic fatty liver disease (NAFLD) are unknown in chronic hepatitis B (CHB) infected patients. Thus, the aim of the study was to investigate the prevalence of thyroid dysfunction and its relationship with NAFLD in CHB.
Consecutive naive CHB infected patients that had undergone liver biopsy and serum thyroid function tests between January 2007 and December 2011 were retrospective analyzed. NAFLD was diagnosed as at least 5% biopsy-proven hepatic steatosis without significant alcohol consumption.
A total of 1154 non-alcoholics with CHB were included, 270 (23.39%) patients were found to have NAFLD, most of them (88.5%) with mild steatosis. The prevalence of hyperthyroidism and hypothyroidism (including subclinical and overt) was 1.56% and 1.64%, respectively, both with similar rates in patients with and without NAFLD (1.85% vs. 1.47%, 1.48% vs. 1.69%, respectively, both P > 0.05). The serum thyroid stimulating hormone (TSH) level in NAFLD patients was significantly higher than that in patients without NAFLD (2.22 ± 2.13 vs. 1.61 ± 1.20 mIU/L, P < 0.05). After adjustment for age and gender, the elevated TSH level was associated with increased odds of having steatosis (OR 1.54, 95% CI 1.049-2.271) instead of viral factors and hepatic inflammation and fibrosis.
Thyroid dysfunction is not common in CHB infected patients, and the prevalence of hypothyroidism in CHB individuals with or without NAFLD is similar. However, increased serum TSH concentration at the normal range is a significant predictor of hepatic steatosis in patients with CHB.