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Association Between Thyroid Hormone Sensitivity and Non-Alcoholic Fatty Liver Disease in Individuals with Normal
Tingting Xu1, Tianshu Han2, Jingyu Zhai3
1Department of Endocrinology, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, 150000, People's Republic of China.
Diabetes, Metabolic Syndrome and Obesity : Targets and Therapy
|September 26, 2025
Summary
Thyroid hormone sensitivity impacts nonalcoholic fatty liver disease (NAFLD) risk in those with normal thyroid function. This association differs between individuals with and without type 2 diabetes mellitus (T2DM).
Area of Science:
- Endocrinology
- Hepatology
- Metabolic Disorders
Background:
- Nonalcoholic fatty liver disease (NAFLD) is a widespread metabolic condition with increasing public health significance.
- Limited and inconsistent evidence exists regarding the link between thyroid hormone levels and NAFLD risk.
Purpose of the Study:
- To investigate the association between thyroid hormone sensitivity and NAFLD in euthyroid individuals.
- To explore how metabolic comorbidities, specifically type 2 diabetes mellitus (T2DM), modify this association.
Main Methods:
- Study included 460 adults with normal thyroid function (229 with T2DM, 231 without).
- NAFLD presence was determined using liver ultrasonography.
- Thyroid hormone sensitivity was assessed using thyroid feedback quantile indices (TFQI-FT4, TFQI-FT3) and FT3/FT4 ratio.
Main Results:
- Higher TFQI-FT4 and TFQI-FT3 were positively associated with NAFLD.
- In T2DM patients, a higher FT3/FT4 ratio correlated with lower NAFLD risk.
- In non-diabetic individuals, a higher FT3/FT4 ratio was positively associated with NAFLD.
Conclusions:
- Thyroid hormone sensitivity is linked to NAFLD development in euthyroid individuals.
- The presence of T2DM appears to influence the relationship between thyroid hormone sensitivity and NAFLD.
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