High parathyroid hormone level as a marker of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis: A systematic review and meta-analysis

Aunchalee Jaroenlapnopparat; Thanitsara Rittiphairoj; Natapat Chaisidhivej; Bradley Walker; Nipith Charoenngam

doi:10.1016/j.dsx.2023.102827

High parathyroid hormone level as a marker of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis: A systematic review and meta-analysis

Diabetes Metab Syndr. 2023 Aug;17(8):102827. doi: 10.1016/j.dsx.2023.102827. Epub 2023 Jul 7.

Authors

Aunchalee Jaroenlapnopparat¹, Thanitsara Rittiphairoj², Natapat Chaisidhivej³, Bradley Walker¹, Nipith Charoenngam⁴

Affiliations

¹ Department of Medicine, Mount Auburn Hospital/Beth Israel Lahey Health, Cambridge, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA.
² Harvard T.H. Chan School of Public Health, Boston, MA, USA.
³ Department of Medicine, Einstein Medical Center Philadelphia, Philadelphia, PA, USA.
⁴ Department of Medicine, Mount Auburn Hospital/Beth Israel Lahey Health, Cambridge, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA; Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. Electronic address: nipith.charoenngam@gmail.com.

PMID: 37451113
DOI: 10.1016/j.dsx.2023.102827

Abstract

Background and aims: Studies have suggested that high parathyroid hormone (PTH) was associated with non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH), although the results from existing studies are inconsistent. Using systematic review and meta-analysis, we aimed to determine the association of PTH with NAFLD and NASH.

Methods: Potentially eligible studies were identified from Embase and Medline databases from using search strategy consisting of terms for "NAFLD/NASH", and "PTH". Eligible study must consist of one group of patients with NAFLD/NASH and another group without NAFLD/NASH. The study must provide mean ± SD PTH in both groups. We extracted such data to calculate mean difference (MD). Pooled MD was then calculated by combining MDs of each study using random-effects model. Funnel plot was used to assess for the presence of publication bias.

Results: A total of 388 articles were identified. After systematic review, 12 studies fulfilled the eligibility criteria and were included into the meta-analysis. The meta-analysis of 10 studies revealed the significant association between high PTH and NAFLD, with the pooled MD of 5.479 (95%CI 0.947-10.011, I² 82.4%). The funnel plot was symmetric and did not suggest publication bias. The meta-analysis of 4 studies revealed the non-significant association between high PTH and NASH, with the pooled MD of 11.955 (95%CI -4.703 - 28.614, I² 81.0%).

Conclusions: High PTH level is significantly associated with NAFLD and can be used as a marker of NAFLD. However, high PTH level is non-significantly associated with NASH. Further studies are needed to increase the sample size and eliminate the confounding factors.

Keywords: Meta-analysis; Nonalcoholic fatty liver disease; Nonalcoholic steatohepatitis; Parathyroid hormone; Systematic review.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Humans
Non-alcoholic Fatty Liver Disease* / diagnosis
Non-alcoholic Fatty Liver Disease* / epidemiology
Non-alcoholic Fatty Liver Disease* / etiology
Parathyroid Hormone

Substances

Parathyroid Hormone