Hypothyroidism and Nonalcoholic Fatty Liver Disease: Pathophysiological Associations and Therapeutic Implications

Tomislav Kizivat; Ivana Maric; Dunja Mudri; Ines Bilic Curcic; Dragan Primorac; Martina Smolic

doi:10.14218/JCTH.2020.00027

Hypothyroidism and Nonalcoholic Fatty Liver Disease: Pathophysiological Associations and Therapeutic Implications

J Clin Transl Hepatol. 2020 Sep 28;8(3):347-353. doi: 10.14218/JCTH.2020.00027. Epub 2020 Jul 21.

Authors

Tomislav Kizivat^{1

2}, Ivana Maric^{1

2}, Dunja Mudri^{1

2}, Ines Bilic Curcic^{1

2}, Dragan Primorac^{1

3

4

5

6

7

8}, Martina Smolic^{1

8}

Affiliations

¹ University of Osijek, Faculty of Medicine, Osijek, Croatia.
² University Hospital Osijek, Osijek, Croatia.
³ St Catherine Specialty Hospital, Zagreb & Zabok, Croatia.
⁴ University of Split School of Medicine, Split, Croatia.
⁵ Eberly College of Science, State College, Penn State University, PA, USA.
⁶ The Henry C Lee College of Criminal Justice & Forensic Sciences, University of New Haven, West Haven, CT, USA.
⁷ University of Rijeka School of Medicine, Rijeka, Croatia.
⁸ University of Osijek Faculty of Dental Medicine & Health, Osijek, Croatia.

Abstract

Nonalcoholic fatty liver disease (NAFLD) is a complex clinical entity which can be secondary to many other diseases including hypothyroidism, characterized by lowering of thyroid hormones and increased thyroid stimulating hormone (TSH). A lot of emerging data published recently advocates the hypothesis that hypothyroid induced NAFLD could be a separate clinical entity, even suggesting possible treatment options for NAFLD involving substitution therapy for hypothyroidism along with lifestyle modifications. In addition, a whole new field of research is focused on thyromimetics in NAFLD/NASH treatment, currently in phase 3 clinical trials. In this critical review we summarized epidemiological and pathophysiological evidence linking these two clinical entities and described specific treatment options with the accent on promising new agents in NAFLD treatment, specifically thyroid hormone receptor (THR) agonist and its metabolites.

Keywords: Hypothyroidism; MAFLD; Metabolic syndrome; NAFLD; Thyromimetics.

Publication types

Review