Endocrine Abstracts

Introduction: Hypothyroidism has been reported as an important factor in the pathogenesis of non-alcoholic fatty liver disease (NAFLD) but studies about the relation between subclinical hypothyroidism and NAFLD have shown contradictory findings. The aim of this study was to conduct a systematic review and meta-analysis exploring the association between subclinical hypothyroidism and NAFLD.

Methods: MEDLINE, EMBASE, Cochrane Library and sources for grey literature (GreyNet international, Google Scholar, Web of Science) were searched from inception to December 2019. The results were supplemented by a manual search of the bibliographies of the articles. The Newcastle Ottawa Scale was used to evaluate the quality of included studies.

ORs were considered as the effect measure with 95% confidence interval and two sided P values was calculated for totals and each study. Sensitivity analysis was implemented by excluding studies with low score of quality. Heterogeneity was assessed using χ² test and I² statistic. Publication bias was evaluated by funnel plot. Review Manager software v.5.3 was used and P < 0.05 was considered statistically significant.

Results: 11 studies were included in the meta-analysis with 41.553 participants (table 1). There was association between subclinical hypothyroidism and NAFLD (OR: 1.27; CI 95%: 1.01–1.60; I²: 79%; P = 0.04) (Figure 1). After excluding one study with low quality, subclinical hypothyroidism was significantly correlated with NAFLD (OR: 1.28; CI 95%: 1.01–1.62; I²: 81%; P = 0.04). Funnel plot did not show indication of publication bias.

Conclusion: Our meta-analysis demonstrated that subclinical hypothyroidism increases the risk of NAFLD. The treatment of subclinical hypothyroidism in patients with NAFLD might improve the progress or the occurrence of the hepatic disease and this potential benefit should be further explored by well-designed clinical studies.