{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T01:03:52Z","timestamp":1793754232272,"version":"4.6.1"},"reference-count":58,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Solid organ transplantation (SOT) is frequently complicated by dysglycemia and metabolic dysfunction\u2013associated steatotic liver disease (MASLD), conditions that accelerate the development of liver fibrosis. Given the recognized thyroid\u2013liver crosstalk, we investigated the association between thyroid function and the enhanced liver fibrosis (ELF) score in SOT recipients with diabetes or prediabetes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Seventy-one adult SOT recipients with diabetes or prediabetes, with ultrasound evidence of liver steatosis and\/or a FIB-4 &amp;gt; 1.3, underwent standardized clinical phenotyping, biochemical profiling, thyroid hormone measurements, ELF testing, and liver stiffness measurement (LSM). Associations with ELF were assessed using correlation analyses and multivariable linear regression adjusted for age, sex, body mass index (BMI), transaminases, glycated haemoglobin, creatinine, haemoglobin, albumin, immunosuppressive drugs, glucagon-like peptide-1 receptor agonist (GLP-1RA) therapy, and transplanted organ type.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Participants had a mean age of 63.1\u00a0\u00b1\u00a09.5 years and BMI of 27.8\u00a0\u00b1\u00a04.8 kg\/m\u00b2. Mean ELF was 9.21\u00a0\u00b1\u00a01.00 (low risk &amp;lt;9.8: 70%; intermediate 9.8\u201311.3: 27%; high \u226511.3: 3%). ELF correlated positively with age (r=0.43, p=0.0002), aspartate aminotransferase (AST; r=0.50, p&amp;lt;0.0001), alanine aminotransferase (ALT; r=0.33, p=0.0059) and creatinine (r=0.39, p=0.0009), and inversely with haemoglobin (r=\u22120.39, p=0.0009), albumin (r=\u22120.38, p=0.0024), controlled attenuation parameter (CAP) (r=\u22120.29, p=0.0171). Among thyroid variables, free triiodothyronine (FT3) correlated inversely with ELF score (r=\u22120.45, p=0.0003), while TSH and FT4 showed no significant association with ELF score (r=0.00, p=0.9859; r=-0.5, p=0.6891). In multivariable analysis (R\u00b2=0.67; p=0.0002), lower FT3 (\u03b2=\u22120.611\u00a0\u00b1\u00a00.288; p=0.0404) and age (\u03b2=0.029\u00a0\u00b1\u00a00.012; p=0.0304) remained independently associated with higher ELF. No association was found between ELF and LSM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In SOT recipients with dysglycemia lower FT3 levels were independently associated with increased ELF scores. This finding suggests a potential link between subtle variations in thyroid function and markers of fibrogenic activity in metabolically vulnerable transplant recipients. Prospective studies are warranted to elucidate the causal directionality of this association and its clinical relevance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2025.1726617","type":"journal-article","created":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T05:11:49Z","timestamp":1767849109000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Thyroid function and liver fibrosis: FT3 levels are inversely and independently correlated with enhanced liver fibrosis score in solid organ transplant patients with dysglycemia"],"prefix":"10.3389","volume":"16","author":[{"given":"Claudia","family":"Leanza","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Ausilia","family":"Giusti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vitale","family":"Miceli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Zito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosaria","family":"Tinnirello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gioacchin","family":"Iannolo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Galante","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabrizio","family":"Emanuele","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Amato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanna","family":"Lo Iacono","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzina","family":"Lo Re","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore","family":"Gruttadauria","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aldo Eugenio","family":"Calogero","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Pinzani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Mattina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,8]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1001\/JAMASURG.2014.2038","article-title":"Survival benefit of solid-organ transplant in the United States","volume":"150","author":"Rana","year":"2015","journal-title":"JAMA Surg"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1007\/S10620-023-08012-1","article-title":"Survival benefit of solid-organ transplantation: 10-year update","volume":"68","author":"Ferreira","year":"2023","journal-title":"Dig Dis Sci"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1210\/ENDREV\/BNAA030","article-title":"Metabolic consequences of solid organ transplantation","volume":"42","author":"Bhat","year":"2021","journal-title":"Endocr Rev"},{"key":"B4","unstructured":"The new antidiabetic agents: cardiovascular and renal protection in post-transplant diabetes mellitus - CellR4\n          \n          \n            \n              Mattina\n              A"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/j.phrs.2019.01.042","article-title":"Management of diabetes mellitus in patients undergoing liver transplantation","volume":"141","author":"Grancini","year":"2019","journal-title":"Pharmacol Res"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1038\/S41574-018-0137-7","article-title":"Post-transplant diabetes mellitus in patients with solid organ transplants","volume":"15","author":"Jenssen","year":"2019","journal-title":"Nat Rev Endocrinol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/j.tcm.2025.01.001","article-title":"Metabolic dysfunction-associated steatotic liver disease and the cardiovascular system","volume":"35","author":"Manolis","year":"2025","journal-title":"Trends Cardiovasc Med"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.2337\/DCI24-0094","article-title":"Metabolic dysfunction\u2013associated steatotic liver disease (MASLD) in people with diabetes: the need for screening and early intervention. 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