{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T06:23:47Z","timestamp":1791872627642,"version":"4.3.4"},"reference-count":69,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T00:00:00Z","timestamp":1781913600000},"content-version":"vor","delay-in-days":170,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"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":["International Journal of Endocrinology"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The relationship between thyroid function indicators and metabolic dysfunction\u2010associated fatty liver disease (MAFLD) has yielded contradictory results. This study aimed to explore the association between thyroid function indicators and MAFLD, as well as the modifying effect of iodine nutritional status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross\u2010sectional analysis utilized nationally representative data from the 2009\u20132012 National Health and Nutrition Examination Survey (NHANES). Different multivariate logistic regression models were constructed to investigate the association between thyroid function indicators and MAFLD. Mediation analyses were performed to explore the mediating roles of MAFLD diagnosis\u2010related variables. Lastly, we analyzed the relationship between thyroid function indicators and MAFLD across different iodine nutritional statuses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After adjusting for covariates unrelated to MAFLD diagnosis, elevated FT3 and FT3\/FT4 and decreased FT4 levels increased the odds of MAFLD across three adjusted models (all\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.05). Besides, FT3 and FT3\/FT4 may be associated with MAFLD through potential pathways involving ALT levels, HDL_C levels, or BMI (\n                      <jats:italic>p<\/jats:italic>\n                      for indirect effect &lt; 0.05). Moreover, the association between thyroid function and MAFLD may vary depending on iodine nutritional status. Specifically, FT4 exhibited an inverse relationship under iodine\u2010deficient conditions, whereas elevated FT3 and FT3\/FT4 levels were positively associated with MAFLD in iodine\u2010adequate populations. Under iodine\u2010excessive conditions, TSH and FT3\/FT4 showed significant involvement in MAFLD (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Thyroid function indicators are associated with MAFLD. This association may potentially be mediated by ALT, HDL_C, and BMI and appears to vary depending on iodine nutritional status, though this modifying effect warrants further validation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/ije\/9291433","type":"journal-article","created":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T09:23:08Z","timestamp":1781947388000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Association Between Thyroid Function Indicators and Metabolic\u2010Associated Fatty Liver Disease: Effect Modification by Iodine Nutritional 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