TOPLINE:

Among children and adolescents with obesity, those with non-alcoholic fatty liver disease (NAFLD) had higher levels of thyroid-stimulating hormone (TSH) than those without; however, levels of free thyroxine (fT4) and free triiodothyronine (fT3) remained unchanged.

METHODOLOGY:

• Researchers in Italy conducted a systematic review and meta-analysis to assess the association between thyroid function parameters and NAFLD in children and adolescents with obesity.
• They identified 10 studies involving 5145 children and adolescents with obesity (50% boys); hepatic steatosis was diagnosed using imaging techniques, histology, or validated non-invasive scores in these studies.
• Thyroid function was assessed using biochemical tests and/or clinical diagnosis of overt or subclinical thyroid dysfunction; serum TSH, fT4, and fT3 levels were compared between children and adolescents with obesity and NAFLD and those without NAFLD.

TAKEAWAY:

• Children and adolescents with obesity plus NAFLD showed significantly higher levels of TSH than those without NAFLD (mean difference, 0.37 mIU/L; 95% CI, 0.07-0.66).
• Neither fT4 nor fT3 levels differed significantly between children and adolescents with obesity who had NAFLD and those who did not.

IN PRACTICE:

"Beyond representing the hepatic manifestation of metabolic dysfunction, NAFLD may also play an active role within the complex interplay between adiposity and thyroid axis alterations," the authors wrote.

SOURCE:

This study was led by Elisa Gatta, Department of Clinical and Experimental Sciences, SSD Endocrinologia, University of Brescia, Brescia, Italy. It was published online on April 09, 2026, in Endocrine Practice.

LIMITATIONS:

Some studies did not clearly report how patients were selected, who were excluded, or when tests were done. Thyroid hormone measurements used different laboratory methods and cutoffs, producing mixed results and making it hard to combine data reliably.

DISCLOSURES:

This study did not receive any funding from any sources. No relevant conflicts of interest were disclosed by the authors.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.