NAFLD and thyroid function: pathophysiological and therapeutic considerations

Nonalcoholic fatty liver disease (NAFLD) is a worldwide rising challenge because of hepatic, but also extrahepatic, complications. Thyroid hormones are master regulators of energy and lipid homeostasis, and the presence of abnormal thyroid function in NAFLD suggests pathogenic relationships. Specifi...

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Published in:Trends in endocrinology and metabolism Vol. 33; no. 11; pp. 755 - 768
Main Authors: Hatziagelaki, Erifili, Paschou, Stavroula A., Schön, Martin, Psaltopoulou, Theodora, Roden, Michael
Format: Journal Article
Language:English
Published: United States Elsevier Ltd 01.11.2022
Subjects:
Endocrinology and Metabolism
Humans
hypothyroidism
Lipogenesis
Liver - metabolism
Non-alcoholic Fatty Liver Disease - etiology
nonalcoholic fatty liver disease
resmetirom
Thyroid Gland
Thyroid Hormone Receptors beta - metabolism
thyroxine
triglycerides
Triglycerides - metabolism
triiodothyronine
thyroxine
nonalcoholic fatty liver disease
resmetirom
triglycerides
hypothyroidism
triiodothyronine
ISSN:1043-2760, 1879-3061, 1879-3061
Online Access:Get full text
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Summary:Nonalcoholic fatty liver disease (NAFLD) is a worldwide rising challenge because of hepatic, but also extrahepatic, complications. Thyroid hormones are master regulators of energy and lipid homeostasis, and the presence of abnormal thyroid function in NAFLD suggests pathogenic relationships. Specifically, persons with hypothyroidism feature dyslipidemia and lower hepatic β-oxidation, which favors accumulation of triglycerides and lipotoxins, insulin resistance, and subsequently de novo lipogenesis. Recent studies indicate that liver-specific thyroid hormone receptor β agonists are effective for the treatment of NAFLD, likely due to improved lipid homeostasis and mitochondrial respiration, which, in turn, may contribute to a reduced risk of NAFLD progression. Taken together, the possible coexistence of thyroid disease and NAFLD calls for increased awareness and optimized strategies for mutual screening and management. Hypothyroidism is present in a significant proportion of people with nonalcoholic fatty liver disease (NAFLD) and may contribute to their higher all-cause as well as cardiovascular mortality. Accelerated hepatic de novo lipogenesis and adipose tissue-derived fatty acid flux to the liver with subsequent insulin resistance may contribute to this association.International guidelines recommend screening for liver disease in all adults with hypo- or hyperthyroidism and for thyroid disease in those with NAFLD.Novel selective thyroid hormone receptor β agonists have been developed to combat NAFLD, but possible extrahepatic effects need close monitoring.
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ISSN:1043-2760
1879-3061
1879-3061
DOI:10.1016/j.tem.2022.08.001