Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/17682
Title: Low Dose Levothyroxine Reduces Intrahepatic Lipid Content in Patients with Type 2 Diabetes Mellitus and NAFLD.
Authors: Bruinstroop, Eveline;Dalan, Rinkoo;Yang, Cao;Bee, Yong Mong;Chandran, Kurumbian;Cho, Li Wei;Soh, Shui Boon;Teo, Eng Kiong;Toh, Sue-Anne;Leow, Melvin Khee Shing;Sinha, Rohit A;Sadananthan, Suresh Anand;Michael, Navin;Stapleton, Heather;Leung, Christopher;Angus, Peter W;Patel, Sheila K;Burrell, Louise M;Chi, Lim Su;Fang, Sum Chee;Velan, S Sendhil;Yen, Paul M
Affiliation: Cardiovascular & Metabolic Disorders Program, Duke-NUS Graduate Medical School, Singapore.. Department of Endocrinology and Metabolism, Amsterdam, The Netherlands..
Department of Endocrinology, Tan Tock Seng Hospital, Singapore
Singapore Clinical Research Institute, Singapore
Department of Endocrinology, Singapore General Hospital, Singapore
Department of Medicine, Ng Teng Fong General Hospital, Singapore
Department of Endocrinology, Changi General Hospital, Singapore
Department of Gastroenterology, Changi General Hospital, Singapore
Department of Endocrinology, National University Health System, Singapore
Cardiovascular & Metabolic Disorders Program, Duke-NUS Graduate Medical School, Singapore
Singapore Institute for Clinical Sciences, A*STAR, Singapore
Duke University, Nicholas School of the Environment, A220 LSRC, Durham, North Carolina, USA
Department of Medicine, Austin Health, The University of Melbourne, Heidelberg, Victoria, Australia
Department of Gastroenterology, Austin Health, Heidelberg, Victoria, Australia
Department of General Medicine, Austin Health, Heidelberg, Victoria, Australia
Department of Endocrinology, Khoo Teck Puat Hospital, Singapore
Saw Swee Hock School of Public Health, National University Health System, Singapore
Diabetes Centre, Admiralty Medical Centre, Singapore
Singapore Bioimaging Consortium, Singapore
Issue Date: 27-Apr-2018
EDate: 2018-04-27
Citation: The Journal of clinical endocrinology and metabolism 2018; online first: 27 April
Abstract: Non-alcoholic fatty liver disease (NAFLD) is highly prevalent in patients with type 2 diabetes mellitus and associated with significant morbidity and mortality. Thyroid hormone (TH) increases β-oxidation of fatty acids and decreases intrahepatic lipid content (IHLC) in rodents with NAFLD. In this study we investigated the possibility of low intrahepatic TH concentration in NAFLD and studied the effect of TH treatment in humans. We performed a phase 2b single arm study in six hospitals in Singapore to study whether TH reduced IHLC. Rats fed a MCD diet to induce NAFLD were used to show intrahepatic thyroid hormone concentrations. Euthyroid patients with type 2 diabetes mellitus and steatosis measured by ultrasonograpy. Levothyroxine was titrated at TSH 0.34-1.70 mIU/L before a 16-week maintenance phase. The primary outcome measure was change in IHLC measured by 1H-MRS after treatment. 20 male patients were included in the per protocol analysis (mean age 47.8±7.8 years, BMI 30.9±4.4 kg/m2, baseline IHLC 13±4 %). After treatment IHLC was decreased by 12 % ± 26 % relative to baseline (absolute change -2 %; 95% CI -3 to 0, p=0.046). Small decreases in BMI (p=0.044), VAT volume (p=0.047), and SAT volume (p=0.045) were observed. No significant changes in glucose regulation or lipid profile occurred. This is the first study demonstrating the efficacy and safety of low dose TH therapy for NAFLD in man, and suggests that TH or TH analogs may be beneficial for this condition.
URI: http://ahro.austin.org.au/austinjspui/handle/1/17682
DOI: 10.1210/jc.2018-00475
ORCID: 0000-0003-1863-7539
0000-0002-0626-1899
PubMed URL: 29718334
Type: Journal Article
Appears in Collections:Journal articles

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