Association Between Thyroid Dysfunction and Non-Alcoholic Fatty Liver Disease: A Systematic Review
Bibliographic record
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
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.022 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.007 | 0.006 |
| Bibliometrics | 0.008 | 0.011 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".