To Assess Non Alcoholic Fatty Liver Disease in Patients with Clinical and Subclinical Hypothyroidism

Abstract

Introduction: NAFLD is emerging as one of the leading causes of end stage liver disease worldwide. Metabolic syndrome is one of the central mechanism in the development of NAFLD. Hypothyroidism is one of the conditions associated with metabolic syndrome. In this study we assess the NAFLD induced by hypothyroidism.

Materials: This study was conducted in tertiary care hospitals attached to BMCRI. 44 patients including both clinical and subclinical hypothyroidism, who were non-diabetic and had no significant alcohol intake, were included in the study. The level of NAFLD was assessed by ultrasound and fibroscan and the same was compared between clinical and subclinical hypothyroid patients.

Result: On comparing the Ultrasonography grading of hepatic steatosis between the clinical and subclinical hypothyroidism group it was found that a significantly higher grade (p < 0.05) of hepatic steatosis was seen in the clinical hypothyroidism group i.e 11 out of 29 subjects had grade III hepatic steatosis (37.9%), Out of the 29 subjects in the clinical hypothyroidism group, F2 F3 and F4 fibrosis grade was seen in 5,5 and 6 individuals respectively. While in the subclinical group 14 out of the 15 individuals had F0 to F1 grade of fibrosis. There was a significantly higher (p < 0.0.5) fibrosis score in Clinical hypothyroidism group when compared to subclinical group.

Conclusion: In our study we observed that Clinical and Subclinical Hypothyroidism are independent risk factors for the development of NAFLD. There was significantly higher level of NAFLD in Clinical Hypothyroidism patients when compared with Subclinical Hypothyroidism subjects. References Younossi Z, Anstee QM, Marietti M, et al. Global burden of NAFLD and NASH: trends, predictions, risk factors and prevention. Nat Rev Gastroenterol Hepatol 2018;15(1):11-20. Kalra S, Vithalani M, Gulati G, et al. Study of prevalence of nonalcoholic fatty liver disease (NAFLD) in type 2 diabetes patients in India (SPRINT). J Assoc Physicians India 2013;61(7):448-53. Taylor PN, Albrecht D, Scholz A, et al. Global epidemiology of hyperthyroidism and hypothyroidism. Nat Rev Endocrinol 2018;14(5):301-316. Kim YA, Park Y. Prevalence and risk factors of subclinical thyroid disease. Endocrinol Metab (Seoul) 2014;29(1):20-29.