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Vol. 154. Issue 1.
Pages 1-6 (January 2020)
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Vol. 154. Issue 1.
Pages 1-6 (January 2020)
Original article
DOI: 10.1016/j.medcle.2019.03.025
Relationship between hypothyroidism and non-alcoholic fatty liver disease in the Spanish population
Relación entre el hipotiroidismo y el hígado graso no alcohólico en una población española
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Alba Martínez Escudéa,b, Guillem Perab,c, Ingrid Arteagab,d, Carmen Expósitob,e, Lluís Rodríguezb,c, Pere Toránb,c, Llorenç Caballeriab,c,
Corresponding author
lcaballeria.bnm.ics@gencat.cat

Corresponding author.
a Centro de Atención Primaria La Llagosta, Instituto Catalan de la Salud, La Llagosta, Barcelona, Spain
b Unidad de Apoyo a la Investigación (USR) Metropolitana Nord, Instituto Universitario de Investigación en Atenció Primaria (IDIAP) Jordi Gol, Mataró, Barcelona, Spain
c Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Spain
d Centro de Atención Primaria Santa Eulàlia, Instituto Catalan de la Salud, Santa Eulàlia de Ronçana, Barcelona, Spain
e Centro de Atención Primaria Sabadell Centro, Instituto Catalán de la Salud, Sabadell, Barcelona, Spain
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Tables (5)
Table 1. Baseline characteristics of all patients with and without NAFLD.
Table 2. Baseline characteristics of subjects according to thyroid function.
Table 3. Association between non-alcoholic fatty liver and hypothyroidism. Multivariate logistic regression model.
Table 4. Relationship between TSH and transaminase levels.
Table 5. Relationship between FT4 and transaminases levels.
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Abstract
Background

Non-alcoholic fatty liver disease (NAFLD) is the most prevalent liver disease in developed countries and is considered the hepatic component of metabolic syndrome (MetS). Recently hypothyroidism has been associated with NAFLD but has never been studied in Spain.

Objectives

To analyze the relationship between hypothyroidism (clinical and subclinical) and NAFLD. To determine the association between MetS with NAFLD and hypothyroidism.

Methods

Cross-sectional, retrospective, population study in subjects ≥45 years from primary care centres in Catalonia included in the SIDIAP database. The data was collected between 2009 and 2013. Variables: socio-demographic data, comorbidities, toxic habits, physical examination, analytical tests and diagnosis of MetS. Descriptive analysis and application of statistical tests for the comparison of variables.

Results

Sample of 10, 116 individuals with a mean age of 61(10) and a predominance of females (63.6 %). The prevalence of hypothyroidism was 9.1 %, with no significant differences according to the presence of NAFLD (p = .631). Hypothyroidism was associated with higher triglyceride levels and a greater prevalence of obesity (p = .003). Greater alteration of AST was detected in individuals with elevated TSH (p = .012) and decreased levels of T4L (p = .037). Alterations in thyroid hormone levels were not associated with a higher prevalence of NAFLD (TSH p = .072 and T4L p = .447). Hypothyroidism was not considered a risk factor for the development of NAFLD (OR .75:95 %CI: .39–1.44, p = .38).

Conclusions

No association was found between hypothyroidism and NAFLD. Prospective studies are needed to clarify a possible relationship between these two diseases.

Keywords:
Non-alcoholic fatty liver disease
Transaminases
Hypothyroidism
Metabolic syndrome
Insulin resistance
Obesity
Resumen
Introducción

El hígado graso no alcohólico (HGNA) es la enfermedad hepática más prevalente en los países desarrollados y se considera el componente hepático del síndrome metabólico (SM). Últimamente el hipotiroidismo se ha asociado al HGNA, pero nunca se ha estudiado en nuestro entorno.

Objetivos

Analizar la relación entre hipotiroidismo (clínico y subclínico) y HGNA. Conocer la asociación de SM con HGNA e hipotiroidismo.

Metodología

Estudio transversal, retrospectivo, poblacional en sujetos ≥45 años procedentes de centros de atención primaria de Cataluña y incluidos en la base de datos SIDIAP. Los datos fueron recogidos entre 2009–2013. Variables: datos socio demográficos, comorbilidades, hábitos tóxicos, exploración física, analítica y diagnóstico de SM. Análisis descriptivo y aplicación de pruebas estadísticas para la comparación de variables.

Resultados

Muestra de 10,116 individuos con edad media 61(10) y predominio del sexo femenino (63,6%). La prevalencia de hipotiroidismo fue del 9,1%, sin encontrar diferencias significativas según la presencia de HGNA (p = 0,631). El hipotiroidismo se asoció a niveles más elevados de triglicéridos y mayor prevalencia de obesidad (p = 0,003). Se detectó mayor alteración de la AST en los individuos con valores incrementados de TSH (p = 0,012) y disminuidos de T4L (p = 0,037). Las alteraciones en los niveles de hormonas tiroideas no se vincularon con mayor prevalencia de HGNA (TSH p = 0,072 y T4L p = 0,447). El hipotiroidismo no se asoció como factor de riesgo para el desarrollo de HGNA (OR 0,75; IC95 %:0,39–1,44; p = 0,38).

Conclusiones

No se ha demostrado asociación entre el hipotiroidismo y el HGNA. Se necesitan estudios prospectivos para esclarecer la relación entre ambas enfermedades.

Palabras clave:
Hígado graso no alcohólico
Transaminasas
Hipotiroidismo
Síndrome metabólico
Resistencia a la insulina
Obesidad

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