Increased Parathormone levels linked to Non-Alcoholic Fatty Liver Disease

Increased parathormone levels are significantly associated with nonalcoholic fatty liver syndrome but not considerably related to non-alcoholic steatohepatitis. Increased parathormone levels can be used as a marker for nonalcoholic fatty liver syndrome. The study results were published in the journal Diabetes & Metabolic Syndrome. 

Nonalcoholic fatty liver disease has become a growing challenge for public health due to the increasing prevalence of diabetes and obesity globally. NAFLD is a common chronic liver disease, associated with various metabolic disorders. Recent literature has suggested that despite inconsistent results, increased parathyroid hormone levels were associated with nonalcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH). Hence researchers conducted a systematic review and meta-analysis to determine the association of parathormone with NAFLD and NASH. 

A search approach centered around the keywords "NAFLD/NASH" and "PTH" was used to find potentially eligible studies in the Embase and Medline databases. The study included groups of patients with NAFLD/NASH and those without NAFLD/NASH. The study must give both groups' mean and standard deviation for PTH. To calculate the mean difference (MD), such data was extracted. Then, using a random-effects model, the MDs from each trial were combined to create the pooled MD. A funnel plot was utilized to determine whether or not there was publication bias. 

Key findings: 

• A total of 388 articles were identified.
• After a systematic review, 12 studies fulfilled the eligibility criteria and were included in the meta-analysis.
• The meta-analysis of 10 studies revealed a significant association between high PTH and NAFLD, with a pooled MD of 5.479. 
• The funnel plot was symmetric and did not suggest publication bias.
• The meta-analysis of 4 studies revealed a non-significant association between high PTH and NASH, with a pooled MD of 11.955.  

Thus, high parathormone levels can be a potential marker for NAFLD as there was a significant association between NAFLD and PTH levels. 

Further reading: Jaroenlapnopparat A, Rittiphairoj T, Chaisidhivej N, Walker B, Charoenngam N. High parathyroid hormone level as a marker of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis: A systematic review and meta-analysis [published online ahead of print, 2023 Jul 7]. Diabetes Metab Syndr. 2023;17(8):102827. doi:10.1016/j.dsx.2023.102827