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World J Hepatol. May 27, 2023; 15(5): 641-648
Published online May 27, 2023. doi: 10.4254/wjh.v15.i5.641
Hypothyroidism and non-alcoholic fatty liver disease: A coincidence or a causal relationship?
Barbara Janota, Elżbieta Szczepańska, Brygida Adamek, Ewa Janczewska
Barbara Janota, Brygida Adamek, Ewa Janczewska, Department of Basic Medical Sciences, Faculty of Public Health in Bytom, Medical University of Silesia in Katowice, Bytom 41-902, Poland
Elżbieta Szczepańska, Department of Human Nutrition, Department of Dietetics, Faculty of Public Health in Bytom, Medical University of Silesia in Katowice, Zabrze 41-808, Poland
Author contributions: Janota B collected data, wrote, and supervised the paper; Janczewska E wrote and supervised the paper; Szczepańska E, Adamek B wrote the paper.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ewa Janczewska, DSc, MD, PhD, Adjunct Professor, Department of Basic Medical Sciences, Faculty of Public Health in Bytom, Medical University of Silesia in Katowice, Piekarska 18, Bytom 41-902, Poland. ejanczewska@sum.edu.pl
Received: December 18, 2022
Peer-review started: December 18, 2022
First decision: February 7, 2023
Revised: February 17, 2023
Accepted: April 6, 2023
Article in press: April 6, 2023
Published online: May 27, 2023
Processing time: 156 Days and 13.2 Hours
Abstract

Non-alcoholic fatty liver disease (NAFLD) is a global problem. It may be caused by metabolic and hormonal disorders, including hypothyroidism. However, non-thyroid causes of NAFLD in people with hypothyroidism, including improper eating behavior and low physical activity, should be acknowledged. This study aimed to present the current literature on whether the development of NAFLD is related to hypothyroidism or a typical consequence of an unhealthy lifestyle in people with hypothyroidism. The results of previous studies do not allow for an unequivocal determination of the pathogenetic relationship between hypothyroidism and NAFLD. Important non-thyroid-initiating factors include providing too many calories in relation to requirements, consuming excessive amounts of monosaccharides and saturated fats, being overweight, and maintaining low physical activity levels. The recommended nutritional model for both hypothyroidism and NAFLD may be the Mediterranean diet, which is rich in fruits and vegetables, polyunsaturated fatty acids, and vitamin E.

Keywords: Non-alcoholic fatty liver disease, Hypothyroidism, Lifestyle, Exercise, Feeding behavior, Body weight

Core Tip: Non-alcoholic fatty liver disease affects 25% of the adult population worldwide; however, the causes of the disease remain unclear. This review answers the question of whether the development of non-alcoholic fatty liver disease is related to hypothyroidism or whether it is a typical consequence of an unhealthy lifestyle in people with hypothyroidism.