TSH and its Correlation in the Development of Fibrosis in Patients with Hypothyroidism in a Tertiary Care Hospital

Introduction and Objectives

Fatty liver disease and hypothyroidism are two prevalent conditions in Mexico that pose significant public health challenges. The increase in their incidence over the past decades is due to changes in lifestyle, diet, and access to healthcare. Although hypothyroidism does not directly cause hepatic fibrosis, it is related to the body's metabolic function. Hypothyroidism can slow down metabolism and lead to lipid accumulation in the liver, a condition known as hepatic steatosis or fatty liver. This condition can progress to steatohepatitis and eventually to hepatic fibrosis, characterized by scar tissue formation. If left untreated, fibrosis can advance to liver cirrhosis with severe complications. Hypothyroidism and fatty liver disease share common risk factors such as obesity, type 2 diabetes, and metabolic disorders. Proper treatment of hypothyroidism and early identification of fatty liver are crucial to prevent progression to fibrosis. It is essential for individuals with hypothyroidism to monitor their liver health and adopt a healthy lifestyle to avoid liver complications. Currently, there are enough studies that validate the association between hypothyroidism and the development of fatty liver with varying degrees of hepatic fibrosis. To identify clinical-demographic characteristics in patients with hypothyroidism evaluated in the endocrinology service and to identify the presence of fibrosis through non-invasive evaluation.

Materials and Patients

Patients with hypothyroidism aged 18 to 80 years of both sexes evaluated by the Endocrinology service with a complete medical record, who do not have risk of alcohol consumption, hepatotropic virus infections, or use of drugs causing hepatotoxicity.

Results

A review of 85 patients with complete medical records was carried out, and a correlation analysis with numerical variables in the SPSS system found that TSH levels do not correlate with the development of hepatic fibrosis, with a Pearson's r = -0.074 (p = 0.519), which is not significant.

Conclusions

In this case series, we report that there is no direct correlation between TSH levels and the development of hepatic fibrosis. However, it is important to highlight that metabolic comorbidities favor the development of fatty liver and, consequently, the possibility of developing hepatic fibrosis. In this series of cases, four cases of advanced fibrosis were found, so it is important to emphasize requesting complete studies in patients with hypothyroidism and to complement with imaging studies.