Research Advances in the Correlation between Hypothyroidism and Metabolic Associated Fatty Liver Disease

甲状腺激素作为重要的代谢调节因子，通过促进脂质输出和氧化、调控脂肪从头合成、调节肝脏胰岛素敏感性以及抑制肝脏糖异生等多种途径，在维持能量代谢平衡、脂肪代谢稳态以及肝脏功能方面发挥着至关重要的作用。因此，甲状腺功能减退作为代谢相关性脂肪性肝病(MAFLD)的一个重要危险因素，两者的相关性一直被广为讨论，但针对甲状腺功能减退是否会导致MAFLD的发病风险增加目前尚无统一结论。本文将从病理生理学基础、流行病学证据以及治疗干预三个方面，系统综述甲状腺功能减退与MAFLD发病的相关性，并探讨甲状腺激素及其类似物对MAFLD的潜在治疗作用，以期为MAFLD的防治提供新的思路和理论依据。Thyroid hormones, as crucial metabolic regulators, play an essential role in maintaining energy balance, lipid homeostasis, and hepatic function through multiple pathways, including promoting lipid export and oxidation, regulating de novo lipogenesis, modulating hepatic insulin sensitivity, and inhibiting hepatic gluconeogenesis. Consequently, hypothyroidism has been widely recognized as a significant risk factor for metabolic dysfunction-associated fatty liver disease (MAFLD), and the relationship between the two has been extensively discussed. However, whether hypothyroidism directly increases the risk of MAFLD remains inconclusive. This article systematically reviews the association between hypothyroidism and MAFLD from three perspectives: pathophysiological mechanisms, epidemiological evidence, and therapeutic interventions. Additionally, it explores the potential therapeutic effects of thyroid hormones and their analogs on MAFLD, aiming to provide new insights and theoretical foundations for the prevention and treatment of MAFLD.