Year: 2025 | Month: November | Volume: 15 | Issue: 11 | Pages: 171-181
DOI: https://doi.org/10.52403/ijhsr.20251122
Association Between Thyroid Dysfunction and Non-Alcoholic Fatty Liver Disease: A Systematic Review
Tanya1, Aryan Kler2, Sunil Singh Bains3
1Medical Officer, MBBS, Pathankot, Punjab, India
2Medical Officer, MBBS, Jalandhar, Punjab, India
3House surgeon, MBBS, Nangal, Punjab, India
Corresponding Author: Sunil Singh Bains
ABSTRACT
Background: Non-alcoholic fatty liver disease (NAFLD) is a leading metabolic liver disorder with growing global prevalence. Thyroid hormones regulate lipid metabolism and hepatic energy balance. This review assessed the association between thyroid dysfunction and NAFLD.
Methods: A systematic search was performed in PubMed, Embase, Scopus, Web of Science, and Cochrane Library up to 2025. Studies evaluating thyroid hormones (TSH, FT3, FT4) in adults with NAFLD were included. Two reviewers independently extracted data and evaluated quality using the Newcastle–Ottawa Scale. Results were summarized descriptively and quantitatively.
Results: Forty studies met inclusion criteria, with 25 rated high quality (NOS≥7). Most showed significantly higher TSH and lower FT3/FT4 in NAFLD than in controls. Subclinical hypothyroidism increased NAFLD risk by 1.5–2.3-fold. Low-normal thyroid function correlated with greater hepatic steatosis and fibrosis. Mean NOS score was 7.4±0.8.
Conclusion: Thyroid dysfunction, particularly subclinical hypothyroidism, is consistently linked with NAFLD presence and severity. Routine thyroid function testing in NAFLD may improve early detection and management.
Key words: NAFLD; Thyroid dysfunction; Hypothyroidism; Subclinical hypothyroidism; Liver fibrosis; Metabolic disease