MICROELEMENT STATUS AS A FACTOR IN THE FORMATION OF METABOLIC DYSFUNCTION-ASSOCIATED STEATOTIC LIVER DISEASE IN HYPOTHYROIDISM

Abstract

The article presents the results of a clinical study devoted to the analysis of microelement status as one of the potential pathogenetic factors in the development of metabolic dysfunction-associated steatotic liver disease (MASLD) in patients with hypothyroidism.
Materials and methods. The study included 110 participants divided into three groups: patients with hypothyroidism and MASLD (n = 50), patients with hypothyroidism without MASLD (n = 45), and practically healthy individuals (controls, n = 15). All participants underwent a comprehensive clinical and laboratory evaluation, which included assessment of liver function (alanine aminotransferase, aspartate aminotransferase, gamma-glutamyltransferase, lactate dehydrogenase, alkaline phosphatase, sorbitol dehydrogenase, cholinesterase), thyroid profile (thyroid-stimulating hormone, free thyroxine, free triiodothyronine), insulin resistance (HOMA-IR), inflammatory marker (C-reactive protein), and concentrations of key microelements (iron, zinc, copper, selenium). Statistical data processing was carried out using STATISTICA 10.0 software.
Results and conclusions. In patients with combined pathology (hypothyroidism + MASLD), the most pronounced disorders were found: elevated liver enzyme activity, insulin resistance, systemic subclinical inflammation, hormonal imbalance, and significant microelement deficiencies compared to other groups. The conducted correlation analysis showed the presence of statistically significant associations between the content of trace elements and indicators of thyroid function, insulin resistance, enzyme activity, and inflammation. The most significant associations were found between selenium and C-reactive protein (r = 0.433, P = 0.002), as well as between iron and thyroid-stimulating hormone (r = – 0.329, P = 0.020), which emphasizes the potential role of micronutrient deficiency in the pathogenesis of combined endocrine and hepatic pathology. The obtained data confirm the rationale for further investigation of micronutrient status as a risk marker for the formation of metabolic dysfunction-associated steatotic liver disease in patients with hypothyroidism and substantiate the importance of a multidisciplinary approach in the management of such patients.