Abstract
BACKGROUND: Thyroid hormones impact on metabolic homeostasis, and low thyroid hormone levels, both systemically and hepatically, have been linked to hepatic steatosis. However, prior studies in this area often lacked quantification of steatosis. Ultrasound attenuation analysis (USAT) is a novel imaging technique for hepatic steatosis detection based on the attenuation coefficient. Our objective in this study was to assess the correlation between thyroid hormone levels and hepatic steatosis via the USAT attenuation coefficient in metabolic dysfunction-associated steatotic liver disease (MASLD) and chronic hepatitis B (CHB) groups. METHODS: This retrospective study included 86 patients with CHB and 45 patients with suspicious MASLD. Demographic information, biochemical parameters, and thyroid hormone levels were analyzed. The severity of steatosis in MASLD or CHB was assessed by USAT. RESULTS: Patients in the MASLD group were more likely to have type 2 diabetes mellitus (T2DM) and hypertension as compared with those in the CHB group (P<0.05). The levels of triiodothyronine (T3) were significantly lower and the platelet counts higher in the MASLD group than in the CHB group (P<0.05). The body mass index (BMI), distance from skin to capsule, USAT values, and alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels in patients with hepatic steatosis were significantly higher than those in patients without hepatic steatosis (P<0.05). Logistic regression analysis indicated a correlation between free triiodothyronine (FT3) level and hepatic steatosis (P=0.04) as well as between free thyroxine (FT4) level and hepatic steatosis (P=0.045). CONCLUSIONS: Quantitative USAT evaluation suggested that hepatic steatosis is strongly correlated with thyroid hormones. These data emphasize the relevance of thyroid hormones for regulating hepatic lipid accumulation and metabolism.