Lipid buildup in liver cells is a hallmark of non-alcoholic fatty liver disease (NAFLD). From basic hepatic steatosis to non-alcoholic steatohepatitis (NASH), which can lead to advanced fibrosis, cirrhosis, and eventually chronic liver failure, NAFLD includes a wide range of liver pathologies.
The term metabolic dysfunction-associated fatty liver disease (MASLD) has taken the role of NAFLD in recent years. The association between hypothyroidism and MASLD has been the subject of a significant number of observational research. However, the results are still unclear, with inconsistent findings from different investigations.
Thus, a sizable population cohort from the UK Biobank was used in the current study to methodically investigate the relationship between hypothyroidism and MASLD. To investigate the underlying possible processes and offer fresh population-based evidence for the influence of hypothyroidism on the risk of MASLD, further stratified, mediation, and nonlinear analyses were conducted.
A Cox proportional hazards model enhanced by several sensitivity analyses was used to examine the relationship between the incidence of hypothyroidism and the development of MASLD using prospective data from the UK Biobank. To evaluate possible effect modifiers, prognostic evaluations and stratified analyses were also carried out.
The study discovered that the probability of MASLD in patients with hypothyroidism was 1.711 times higher than that of individuals without hypothyroidism after properly controlling for a number of variables. A significantly higher risk of MASLD development was linked to both subtypes of hypothyroidism, namely surgical related hypothyroidism (SRH) and non-surgical related hypothyroidism (NSRH).
There is a 1.710-fold increase in risk for NSRH and a 1.763-fold increase for SRH. When it came to the risk of MASLD in people with NSRH, stratified analysis showed an interaction impact between gender and BMI. The importance of certain biomarkers in clarifying the connection between hypothyroidism and MASLD was demonstrated by mediation analysis. Also, this link was found to be significantly mediated by red cell distribution width, HbA1c, C-reactive protein, and total protein. Overall, people with hypothyroidism may be more susceptible to MASLD, especially if they have high levels of inflammatory markers.
Source:
Wang, H., Zheng, C., & Wang, P. (2025). Exploring the nexus between hypothyroidism and metabolic dysfunction-associated steatotic liver disease: a UK biobank cohort study. Scientific Reports, 15(1). https://doi.org/10.1038/s41598-025-91221-7
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