S2697 Higher TSH Within the Normal Range Is Linked to Increased Risk of NAFLD/MASLD in Euthyroid Individuals: A Meta-Analysis
Bibliographic record
Abstract
Introduction: Thyroid function may influence liver fat metabolism, even within the normal (euthyroid) range. However, the link between serum thyroid-stimulating hormone (TSH) levels and the risk of non-alcoholic fatty liver disease (NAFLD), now termed metabolic dysfunction-associated steatotic liver disease (MASLD), remains unclear in euthyroid adults. This meta-analysis aimed to assess this association using both continuous and categorical TSH levels. Methods: A systematic review was conducted in accordance with PRISMA guidelines. PubMed, Embase, Scopus, and Google Scholar databases were searched through May 2025 using terms including “euthyroid,” “TSH,” “thyroid-stimulating hormone,” “NAFLD,” and “MASLD.” Studies were eligible if they evaluated the association between serum TSH and NAFLD/MASLD among euthyroid adults. Two independent reviewers performed data extraction and quality assessment using the Newcastle-Ottawa Scale. Meta-analyses were performed using a random-effects model, with pooled odds ratios (ORs) and 95% confidence intervals (CIs). Continuous and categorical TSH levels were analyzed separately. Heterogeneity was assessed using I² statistics, and leave-one-out sensitivity analysis was conducted. Results: The meta-analysis included 7 studies, comprising 37,625 euthyroid individuals. In the categorical analysis, higher serum TSH levels were significantly associated with increased odds of NAFLD/MASLD (pooled OR: 1.33, 95% CI: 1.15–1.53, I² = 31.8%, P = 0.22). Effect estimates ranged from 1.29 to 1.46 in leave-one-out sensitivity analysis, indicating no single study unduly influenced the overall result. In the continuous analysis, each unit increase in TSH was associated with higher odds of NAFLD/MASLD (pooled OR: 1.52, 95% CI: 0.89–2.59), though substantial heterogeneity was observed (I² = 85.2%, P < 0.01). Sensitivity analysis showed that excluding Berg et al. increased the pooled estimate (OR: 1.95, 95% CI: 1.38–2.76), suggesting this study may have moderated the overall association. Together, these findings indicate a positive association between higher TSH levels and NAFLD/MASLD risk in euthyroid individuals, with more consistent results in the categorical analysis. Conclusion: Higher TSH levels within the normal range are associated with increased NAFLD/MASLD risk in euthyroid adults, especially in biopsy-based studies. TSH may aid early risk detection. Further research is needed to clarify mechanisms and clinical relevance.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.011 | 0.025 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.014 | 0.048 |
| Bibliometrics | 0.005 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
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".