{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T18:12:50Z","timestamp":1789409570075,"version":"build-2803163510"},"reference-count":66,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,1,23]],"date-time":"2024-01-23T00:00:00Z","timestamp":1705968000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2024,1,23]],"date-time":"2024-01-23T00:00:00Z","timestamp":1705968000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Thyroid axis is currently under investigation as a therapeutic target in metabolic dysfunction\u2010associated steatotic liver disease (MASLD). Thyroid function was examined herein in the full spectrum of disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Subjects were recruited and had liver biopsies in two Gastroenterology\u2010Hepatology Clinics (Greece and Australia) and one Bariatric\u2010Metabolic Surgery Clinic (Italy). The main working sample was\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009677 subjects with MASLD after excluding subjects with abnormal free thyroxine levels. Participants were classified according to thyroid\u2010stimulating hormone (TSH) standard criteria: Subclinical hyperthyroidism (&lt;0.4\u2009uIU\/mL); Euthyroidism with relatively low (0.4 to &lt;2.5\u2009uIU\/mL); euthyroidism with relatively high (2.5\u20134.0\u2009uIU\/mL); subclinical hypothyroidism (&gt;4\u2009uIU\/mL).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      TSH as a continuous variable was positively associated with significant fibrosis (\n                      <jats:italic>F<\/jats:italic>\n                      \u2009\u2265\u20092), metabolic dysfunction\u2010associated steatohepatitis (MASH) and at\u2010risk MASH. Subclinical hypothyroidism was associated with fibrosis\n                      <jats:italic>F<\/jats:italic>\n                      \u2009\u2265\u20092 (odds ratio [OR]\u2009=\u20093.47, 95% confident interval [CI] [1.50, 8.05],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.02), MASH (OR\u2009=\u20093.44, 95% CI [1.48, 7.98]\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.001) and at\u2010risk MASH (OR\u2009=\u20093.88, 95% CI [1.76, 8.55],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.001), before and after controlling for adiposity, central obesity, and insulin resistance. When leptin, adiponectin, or growth differentiation factor\u201015 were examined as moderators, significance was lost. Sex\u2010specific analysis revealed a strong association between TSH and the presence of significant fibrosis among women, eliminated only when adipokines\/mitokines were adjusted for. Restricted cubic spline analysis revealed associations between TSH and liver outcomes (\n                      <jats:italic>p<\/jats:italic>\n                      \u2010values\u2009&lt;\u2009.01) with inflection points for fibrosis\n                      <jats:italic>F<\/jats:italic>\n                      \u2009\u2265\u20092 being 2.49, for MASH being 2.67 and for at\u2010risk MASH being 6.96.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These observations provide support for studies on the administration of thyroid hormone in MASLD therapeutics for subclinical hypothyroidism and liver\u2010specific thyroid receptor agonists for subjects across the TSH continuum.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/liv.15847","type":"journal-article","created":{"date-parts":[[2024,1,24]],"date-time":"2024-01-24T01:55:15Z","timestamp":1706061315000},"page":"848-864","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Thyroid function, adipokines and mitokines in metabolic dysfunction\u2010associated steatohepatitis: A multi\u2010centre biopsy\u2010based observational study"],"prefix":"10.1111","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1558-194X","authenticated-orcid":false,"given":"Matina","family":"Kouvari","sequence":"first","affiliation":[{"name":"Department of Medicine, Beth Israel Deaconess Medical Center Harvard Medical School  Boston Massachusetts 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