THYROID FUNCTION TIED TO MORTALITY IN NAFLD

Good evening dear friends and fellow colleagues, Here is an update regarding Hypothyroidism tied to mortality in NAFLD. According to new research, low Thyroid function in combination with NAFLD ( Non alcoholic fatty liver disease) is associated with increased risk of all cause and cardiovascular mortality. This was published online in The American journal of Gastroenterology June 3 , 2020. The prevalence of NAFLD was defined as Ultrasonographically diagnosed hepatic steatosis with out coexisting liver disease was 33.9% including 19.7% with moderate to severe Steatosis. High levels of TSH in euthyroid state can negatively affect metabolic health, the researchers note . Low Thyroid function was associated with a 29% increase in the risk of NAFLD. Low thyroid function was associated with a significantly higher risk for all cause mortality in those with NAFLD but not those without NAFLD. Low thyroid function was also associated with a higher risk of cardiovascular mortality in entire population and in those with NAFLD. There was no such association with Non- NAFLD group. The researchers conclude that although NAFLD in and of itself doesn't increase the risk of all cause or cause specific mortality. NAFLD with Increasing TSH levels is associated with all cause mortality particularly cardiovascular mortality. This study was done by Dr Donghee kim of Stanford University school of medicine, in California and the researchers collected data from NHANES III ( National health and Nutrition examination survey) from 1988 to 1994 on more than 10,000 participants. With regards, Dr Sepuri Tirumala Devi.

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Sir good information. We do have many cases of NAFLD in diabetics too. Ofcourse it's not related to present topic.as u are an expert in diabetes people claim the use of vit E empirically. Of course pioglitazone is a proven effective drug in this ailment. Pl highlight ur views on the management of this issue of NAFLD in diabetics

Sir, As you rightly said combination of Pioglitazone and Vitamin E is the main stay of drug therapy in NAFLD with or without Diabetes and Metformin also has got a role in reducing the severity of NAFLD. Life style modification. ie. Diet Exercise along with Weight reduction is the main stay of non pharmacological therapy which is even more important than pharmacological therapy. We have to treat NAFLD very seriously as it leads to NASH, Cirrhosis, and finally HCC (Hepatocellular carcinoma.) Of course NAFLD cannot be taken so light at all in the current scenario as it leads to Type 2 DM and vice-versa. Roughly around 70 to 80% of the Type 2 DM have NAFLD which is seen typically as fatty liver in the USG abdomen and even more with alcoholics in the form of AFLD and ASH. Still today many of the clinicians take the scenario so light which shouldn't be in the current scenario keeping NAFLD in the view the future marker of CV mortality as well as HCC. SO HIT NAFLD EARLY AND HIT HARD.
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It's a retrospective study & not clear how many factors for cv mortality were assessed , should take it with a pinch of salt

Thanks for update, m'm

Thank you doctor
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Thanks

Thank you doctor
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