High PTH Level a Marker for NAFLD and Possibly NASH

TOPLINE:

A high parathyroid hormone (PTH) level was significantly associated with nonalcoholic fatty liver disease (NAFLD) and nonsignificantly associated with nonalcoholic steatohepatitis (NASH) in a meta-analysis.

METHODOLOGY:

  • The researchers conducted a systematic review and meta-analysis of 12 case-control studies of patients with NAFLD/NASH and a comparison group without NAFLD/NASH.

  • All studies had data on mean PTH levels in cases and controls.

  • Pooled weighted mean difference (WMD) was calculated by combining WMDs of each study using a random-effects model.

TAKEAWAY:

  • A meta-analysis of 10 studies with 1051 patients with NAFLD and 1510 controls revealed a significant association between high PTH level and NAFLD, with a pooled WMD of 5.479.

  • A meta-analysis of four studies with 99 patients with NASH and 143 controls revealed a trend toward an association of high PTH level and NASH, with a pooled WMD of 11.995; statistical significance was not achieved owing to inadequate power.

  • Both meta-analyses had high statistical heterogeneity (I 2 of 82.4% for NAFLD and 81.0% for NASH).

IN PRACTICE:

“These findings may have clinical implications as they may suggest that high PTH level could be another biochemical marker of presence of NAFLD and possibly NASH,” the researchers wrote.

SOURCE:

This study was led by Aunchalee Jaroenlapnopparat, MD, Mount Auburn Hospital/Beth Israel Lahey Health, Cambridge, Massachusetts. It was published online July 7 in Diabetes & Metabolic Syndrome: Research & Reviews. The study had no funding.

LIMITATIONS:

This systematic review and meta-analysis included observational studies, which might not show a causal relationship owing to potential confounding effects. Both meta-analyses demonstrated high statistical heterogeneity, probably due to differences in study design, population, and quality among the included studies. The number of studies and participants in the NASH-related analysis were limited, which may have compromised the statistical power of the analysis.

DISCLOSURES:

The authors have no relevant conflicts of interest.

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