{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T04:52:00Z","timestamp":1791867120966,"version":"4.3.4"},"reference-count":33,"publisher":"The Korean Association for the Study of the Liver","issue":"1","license":[{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"HKSAR","award":["14106923"],"award-info":[{"award-number":["14106923"]}]},{"DOI":"10.13039\/100005564","name":"Gilead Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005564","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Illuminatio Medical Technology"},{"name":"Abbott"},{"name":"Astra Zeneca"},{"DOI":"10.13039\/100004326","name":"Bayer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004326","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100001003","name":"Boehringer Ingelheim","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001003","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100015769","name":"Dexcom","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100015769","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Eli-Lilly"},{"name":"Kyowa Kirin"},{"name":"Merck Serono"},{"DOI":"10.13039\/100009947","name":"Merck Sharp and Dohme","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009947","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Nestle"},{"name":"NovoNordisk"},{"DOI":"10.13039\/100004319","name":"Pfizer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004339","name":"Sanofi","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004339","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Zuellig Pharma"}],"content-domain":{"domain":["e-cmh.org"],"crossmark-restriction":true},"short-container-title":["CMH"],"published-print":{"date-parts":[[2026,1,1]]},"abstract":"<jats:p>Background\/Aims: Previous studies suggest that hypothyroidism is associated with metabolic dysfunction-associated steatotic liver disease (MASLD) and its histological severity, but clinical outcome data are largely lacking. We aimed to study the impact of hypothyroidism on liver-related events (LREs).Methods: Patients with MASLD were identified from a territory-wide registry in Hong Kong during 2000\u20132024. Thyroid status was determined using diagnosis codes and thyroid function tests. The primary outcome, LRE, was defined as a composite of hepatic decompensation, hepatocellular carcinoma, liver transplantation, and liver-related death.Results: A total of 20,478 patients with MASLD were included in the final analysis (mean age 56.4\u00b113.2 years; 43.9% male). At baseline, 18,178 (88.8%) patients were euthyroid, 598 (2.9%) were hyperthyroid, and 1,702 (8.3%) were hypothyroid. Compared with euthyroid patients, both hyperthyroidism and overt hypothyroidism were associated with cirrhosis. At a median follow-up of 4.8 years, 179 patients developed LREs, and 26 died from liver disease. Compared with patients with normal serum thyroid-stimulating hormone (TSH) levels of 0.4\u20134 mIU\/L, those with subclinical (4\u201310 mIU\/L; adjusted time-dependent cause-specific hazard ratio [aCSHR], 2.49; 95% CI, 1.51\u20134.13) and overt hypothyroidism (&gt;10 mIU\/L; aCSHR, 4.91; 95% CI, 1.56\u201315.47) had an increased risk of LREs. Time-dependent, but not baseline, TSH and thyroid status were associated with LRE risk.Conclusions: Subclinical and overt hypothyroidism are associated with an increased risk of LREs in a dose-dependent manner. The association with time-dependent but not baseline thyroid status underscores the importance of thyroid monitoring and suggests that correction of hypothyroidism may mitigate LRE risk.<\/jats:p>","DOI":"10.3350\/cmh.2025.0860","type":"journal-article","created":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T07:29:54Z","timestamp":1764574194000},"page":"353-367","update-policy":"https:\/\/doi.org\/10.3350\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Hypothyroidism and the risk of liver-related events in patients with metabolic dysfunction-associated steatotic liver disease"],"prefix":"10.3350","volume":"32","author":[{"given":"Xinrui","family":"Jin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sherlot Juan","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jimmy 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