Journal of Clinical and Translational Hepatology

Journal of Clinical and Translational Hepatology

Tuesday, 06 / 15 / 2021



Hypothyroidism and Nonalcoholic Fatty Liver Disease: Pathophysiological Associations and Therapeutic Implications

Tomislav Kizivat#,1,2, Ivana Maric1,2, Dunja Mudri1,2, Ines Bilic Curcic#,1,2, Dragan Primorac1,3,4,5,6,7,8 and Martina Smolic*,1,8 

1  University of Osijek, Faculty of Medicine, Osijek, Croatia
2  University Hospital Osijek, Osijek, Croatia
3  St Catherine Specialty Hospital, Zagreb & Zabok, Croatia
4  University of Split School of Medicine, Split, Croatia
5  Eberly College of Science, State College, Penn State University, PA, USA
6  The Henry C Lee College of Criminal Justice & Forensic Sciences, University of New Haven, West Haven, CT, USA
7  University of Rijeka School of Medicine, Rijeka, Croatia
8  University of Osijek Faculty of Dental Medicine & Health, Osijek, Croatia
#Both authors contributed equally to this manuscript.
*Correspondence to: Martina Smolic, University of Osijek, Faculty of Medicine, Department of Pharmacology; Faculty of Dental Medicine and Health, Department of Pharmacology and Biochemistry, J. Huttlera 4, 31000 Osijek, Croatia. Tel: +385-31-512-800, Fax: +385-31-512-833, E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

Journal of Clinical and Translational Hepatology 2020;8(3):347-353 DOI: 10.14218/JCTH.2020.00027
Received: April 7, 2020 Accepted: June 28, 2020 Published onlineJuly 21, 2020


Nonalcoholic fatty liver disease (NAFLD) is a complex clinical entity which can be secondary to many other diseases including hypothyroidism, characterized by lowering of thyroid hormones and increased thyroid stimulating hormone (TSH). A lot of emerging data published recently advocates the hypothesis that hypothyroid induced NAFLD could be a separate clinical entity, even suggesting possible treatment options for NAFLD involving substitution therapy for hypothyroidism along with lifestyle modifications. In addition, a whole new field of research is focused on thyromimetics in NAFLD/NASH treatment, currently in phase 3 clinical trials. In this critical review we summarized epidemiological and pathophysiological evidence linking these two clinical entities and described specific treatment options with the accent on promising new agents in NAFLD treatment, specifically thyroid hormone receptor (THR) agonist and its metabolites.


NAFLD, MAFLD, Hypothyroidism, Metabolic syndrome, Thyromimetics

Journal of Clinical and Translational Hepatology 2020 vol. 8, 347-353  [ Html  ] [ PDF Full-text ]

© The Authors 2020. This article is published under the terms of the Creative Commons Attribution-Noncommercial License (CC BY-NC 4.0), which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license.


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