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The most common cause in the UK is autoimmune thyroiditis (Hashimoto's disease)

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2.2 Pathogenic mechanisms underlying hypothyroidism-associated MAFLD 2.2.1 Simple steatosis: lipid accumulation and impaired lipophagy Hypothyroidism promotes hepatic lipid accumulation through impaired lipid catabolism, enhanced de novo lipogenesis, and defective autophagic clearance of lipid droplets