MetroHealth Medical Center Cleveland, OH, United States
Erin Walsh, DO1, Sophie Trujillo, DO1, Sara Kamionkowski, DO1, Imad Asaad, MD2 1MetroHealth Medical Center, Cleveland, OH; 2Cleveland Clinic Foundation, Cleveland, OH
Introduction: Non-alcoholic fatty liver disease (NAFLD) refers to fatty infiltration of the liver, with or without inflammation and fibrosis. NAFLD is the most common cause of liver disease in Western countries. Numerous studies have demonstrated a positive association between hypothyroidism and the development of non-alcoholic fatty liver disease. It has been proposed that treatment with thyroid hormone could reduce the risk of developing liver disease. Our aim is to determine if hypothyroidism patients treated with levothyroxine, a thyroid hormone analogue, are at lower risk of developing NAFLD and cirrhosis.
Methods: We performed a retrospective analysis in the IBM Explorys database (1999-2021), a pooled, de-identified clinical database of over 75 million unique patients across the United States. Patient populations were identified using SNOMED and ICD codes. Inclusion criteria were patients with hypothyroidism and patients taking levothyroxine. Adverse events included a diagnosis of NAFLD, non-alcoholic steatohepatitis (NASH), or cirrhosis. Odds ratios (OR) with a 95% confidence interval (CI) were calculated for NAFLD/NASH and cirrhosis in hypothyroidism and patients on levothyroxine.
Results: 3,720,320 patients with hypothyroidism were included in this study. Patients with hypothyroidism were at increased risk of developing NAFLD/NASH (OR 7.8058, 95% CI 7.6617 to 7.9527, P-value < 0.0001) or cirrhosis (OR 5.7648, 95% CI 5.7176 – 5.8124, p-value < 0.0001). Patients taking levothyroxine were not at lower risk of developing NASH/NAFLD (OR 6.7248, 95% CI 6.5265 to 6.9291, p-value < 0.0001) or cirrhosis (OR 4.3715, 95% CI 4.3069 to 4.4371, p-value < 0.0001).
Discussion: Our study confirmed a positive clinical association between hypothyroidism and the development of liver disease such as NAFLD/NASH and cirrhosis. Treatment of hypothyroidism with levothyroxine did not positively impact the progression of liver disease to NAFLD/NASH or cirrhosis. Further research is needed to understand how to modulate thyroid hormone to decrease the progression of liver disease in hypothyroid patients.
Erin Walsh indicated no relevant financial relationships.
Sophie Trujillo indicated no relevant financial relationships.
Sara Kamionkowski indicated no relevant financial relationships.
Imad Asaad indicated no relevant financial relationships.
Erin Walsh, DO1, Sophie Trujillo, DO1, Sara Kamionkowski, DO1, Imad Asaad, MD2. P1792 - Hypothyroidism-Related Development of Non-Alcoholic Fatty Liver Disease - Is Levothyroxine the Answer?, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.