Correlation between serum thyroid hormone level and metabolic steatohepatitis: A retrospective study

Metabolic steatohepatitis (MASH) is a common liver disease, and its association with serum thyroid hormone levels is unclear. This study aimed to analyze the association between MASH and serum levels of thyroid hormones in patients with normal thyroid function.

638 non-alcoholic fatty liver disease patients hospitalized in our hospital from March 2021 to March 2024 were retrospectively selected and divided into MASH (n = 262) and non-MASH (n = 376) groups based on the diagnosis made by expert pathologists. The clinical data of the patients were collected, and multivariate logistic regression analysis was utilized to investigate the association between MASH and serum thyroid hormone levels.

Serum levels of thyroid-stimulating hormone (TSH) and free triiodothyronine (FT3) in the MASH group were significantly higher compared to the non-MASH group, and serum free thyroxine (FT4) levels were lower than those in non-MASH group. The FT3/FT4 ratio in MASH group was higher than that in non-MASH group (P < 0.05). Logistic regression analysis showed that serum levels of TSH, FT3 and FT4 were independent influencing factors for MASH. The area under receiver operating characteristic (ROC) curve of TSH, FT3, FT4 and FT3/FT4 for predicting the occurrence of MASH were 0.944, 0.973, 0.753 and 0.959, respectively.

Elevated serum levels of TSH, FT3, and the FT3/FT4 ratio, along with decreased serum FT4 levels, were independently associated with an increased risk of MASH.