الفهرس 
Introduction.Only 14 pages are availabe for public view
 |  | from | 113 |  |  |
| | | from | 113 | | |
Abstract
Non-alcoholic fatty liver disease (NAFLD) is one of the most common chronic liver diseases. NAFLD includes a broad range of conditions, such as simple steatosis and non-alcoholic steatohepatitis, which could progress to cirrhosis and hepatocellular carcinoma. In addition, NAFLD can increase the incidence of cardiovascular disease. Therefore, it is very important to identify the risk factors of NAFLD for the development of new preventive or therapeutic strategies. NAFLD is considered the hepatic manifestation of metabolic syndrome, which is associated with insulin resistance. Metabolic disorders, such as hypertension, hyperlipidemia, diabetes, and central obesity, are known risk factors of NAFLD. Thyroid hormones regulate various metabolic processes involving carbohydrates, lipids, and proteins. Thyroid hormones also play important roles in hepatic lipid metabolism and hepatic insulin resistance. Hypothyroidism is associated with reduced lipolysis and decreased liver uptake of free fatty acids derived from triglycerides. In recent years, the correlation between overt or subclinical hypothyroidism and NAFLD has been discussed and is considered controversial. In addition, the relationship between NAFLD and thyroid function parameters remains unclear. In the current study we aimed to evaluate the relationship between serum level of Thyroid Stimulating Hormone (TSH) within normal reference range and Non Alcoholic fatty liver Disease (NAFLD). 40 patients with NAFLD and a control group of 20 healthy individuals, who were attendants of Outpatient Clinic of Internal Medicine Department of Tanta University Hospitals and EL-Menshawy General Hospital, were included in the study. They were divided into 2 groups: • group I→ Twenty healthy individuals with No NAFLD. • group II→ Forty patients with NAFLD. group II was subdivided into: group II-a → patients with NAFLD who have serum level of TSH (≥0.3 &<2.5 mU/L). group II-b →patients with NAFLD who have serum level of TSH (≥2.5 &≤4.1 mU/L). In the current study, we found no significant difference between groups as regard gender (p value=0.935), age (p value=0.345) or smoking (p value=0.803), WC and BMI (p value=0.994, 0.988, respectively). This study revealed significant difference between groups regarding serum levels of, AST (p value=0.011), FT4 (p value=0.005), FT3, TSH, HDL, bilirubin and Anti –TPO (p value< 0.001), but the difference between groups was non-significant regarding serum levels of, ALT (p value=0.275), triglyceride (p value=0.423), INR (p value=0.892), albumin (p value=0.348), and fasting glucose (p value=0.942). Also, this work showed significant positive correlation between serum TSH level and Anti-TPO level and grade of NAFLD in group II (p value=0.009 and 0.008, respectively). Also, the correlation between serum TSH level and grade of NAFLD was positively significant in subgroup II-a and subgroup II-b (p value<0.001, 0.002, respectively). Subgroup II-a, showed significant negative correlation between serum TSH level and AST level (p value=0.020). In the present study, univariate regression analysis showed that serum levels of AST, FT3, FT4 and Anti-TPO were independent risk factors of NAFLD, while in multivariate analysis the only independent risk factor of NAFLD was Anti-TPO serum level.