{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T06:24:26Z","timestamp":1791872666619,"version":"4.3.4"},"reference-count":34,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2024,1,23]],"date-time":"2024-01-23T00:00:00Z","timestamp":1705968000000},"content-version":"vor","delay-in-days":32,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100020084","name":"Guangzhou Science and Technology Bureau","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100020084","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,12,22]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Recent studies have found that thyroid function may be associated with the occurrence and development of advanced liver fibrosis in patients with metabolic dysfunction-associated fatty liver disease (MAFLD). However, the majority of such research has consisted of cross-sectional studies. This retrospective cohort study aimed to investigate the effect of low-normal thyroid function on advanced liver fibrosis in MAFLD patients over a 5-year period.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This retrospective cohort study enrolled 825 outpatients and inpatients with MAFLD who attended the Third Affiliated Hospital of Sun Yat-sen University (Guangzhou, China) between January 2011 and December 2018. Based on plasma thyroid hormone and thyroid-stimulating hormone levels, these patients were divided into two groups, namely a low-normal thyroid function group and a strict-normal thyroid function group. The fibrosis-4 score was used to assess advanced liver fibrosis. A chi-square test was conducted to compare the occurrence of advanced fibrosis between the groups.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among the 825 MAFLD patients, 117 and 708 were defined as having low-normal thyroid function and strict-normal thyroid function, respectively. Follow-up data were available for 767 patients (93.0%) during a 5-year period. Eight (7.5%) MAFLD patients with low-normal thyroid function and 26 (3.9%) with strict-normal thyroid function developed advanced liver fibrosis and the cumulative incidence was not significantly different (P\u2009=\u20090.163). Stratification analysis showed that the lean MAFLD patients (body mass index \u2264 23\u2009kg\/m2) with low-normal thyroid function had a higher risk of advanced liver fibrosis than the lean MAFLD patients with strict-normal thyroid function (P\u2009&amp;lt;\u20090.05).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Low-normal thyroid function is associated with advanced liver fibrosis among lean MAFLD patients.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/gastro\/goad076","type":"journal-article","created":{"date-parts":[[2024,1,23]],"date-time":"2024-01-23T18:53:51Z","timestamp":1706036031000},"source":"Crossref","is-referenced-by-count":4,"title":["Association between low-normal thyroid function and advanced liver fibrosis in metabolic dysfunction-associated fatty liver disease patients: a retrospective cohort study"],"prefix":"10.1093","volume":"12","author":[{"given":"Zixuan","family":"Li","sequence":"first","affiliation":[{"name":"Department of Epidemiology, School of Public Health, Sun Yat-sen University , Guangzhou, Guangdong, P. R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoying","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, The Third Affiliated Hospital of Sun Yat-sen University , Guangzhou, Guangdong, P. R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zebin","family":"Chen","sequence":"additional","affiliation":[{"name":"Center of Hepato-Pancreatico-Biliary Surgery, The First Affiliated Hospital, Sun Yat-sen University , Guangzhou, Guangdong, P. R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiuqing","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, The Third Affiliated Hospital of Sun Yat-sen University , Guangzhou, Guangdong, P. R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiqing","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health, Sun Yat-sen University , Guangzhou, Guangdong, P. R. 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