High PTH Level a Marker for NAFLD and Possibly NASH


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.


  • 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.


  • 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).


“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.


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.


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.


The authors have no relevant conflicts of interest.

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