Non-alcoholic fatty liver disease (NAFLD) is a major global health problem characterised by accumulation of fat in the liver. NAFLD develops in patients with obesity, diabetes type 2, dyslipidaemia and insulin resistance. The presence of excess fat in the liver can long be a silent process; however, as the disease progresses, the liver will be unable to function normally, which in this stage the damage is non-reversible. Currently, it is estimated that 30-40% of Singaporeans are affected with this disease but with no available treatment until now.

Dr Eveline Bruinstroop and Professor Yen from Duke-NUS Medical School, in collaboration with the Singapore Clinical Research Institute (SCRI), and Dr. S. Sendhil Velan from the Agency of Science and Technology Research (A*STAR)’s Singapore Bioimaging Consortium (SBIC), recently completed a clinical study that showed how low dose thyroid hormone supplementation may be beneficial for reducing fatty liver in male diabetic patients with NAFLD.

20 NAFLD patients with stable type 2 diabetes and normal thyroid function were treated with thyroxine hormone therapy for 4 months, with the particular dosage that was tailored to obtain the desirable levels individually. It was found that patients that had a larger decrease in liver lipid content also showed improvements in their diabetes.

(From left to right): A*STAR, Assoc Prof Teoh Yee Leong, CEO, SCRI; Dr. S. Sendhil Velan, Head of SBIC Metabolic Imaging Group and Dr Eveline Bruinstroop, Research Fellow, Cardiovascular and Metabolic Disorders Research Program in Duke-NUS Medical School and an image captured by the 3T MRI/MRS Scanner.

Professor Yen, who is from the Cardiovascular and Metabolic Disorders Programme at Duke-NUS Medical School, said, “This is the first clinical study that showed low dose thyroid hormone decreases both liver fat as well as overall body fat in a safe manner in male type 2 diabetic patients with NAFLD. The decrease in liver fat also correlates with an improvement in diabetes control after treatment. This pilot study provides a strong rationale for further investigation, development, and testing of thyroid hormone or thyroid hormone analogues in diabetic patients with NAFLD”.

In this study, SBIC’s Dr S. Sendhil Velan and his team implemented non-invasive magnetic resonance imaging and spectroscopic techniques to quantitatively assess visceral fat, subcutaneous fat and liver fat before and after TH treatment in NAFLD patients. SBIC plans to conduct more studies to evaluate the changes in fat composition within liver fat in response to an intervention.

The treatment is currently still in the early stages of trial and hopefully it will be made available to the public soon. Nevertheless, one can only look forward to further development in medical research to improve health outcomes.

Photo credit: Pixabay, SCRI, Duke-NUS Medical School and A*STAR.