Study Of Thyroid Function In Patients With Cirrhosis Of Liver
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Keywords
Cirrhosis of liver, Free T3,T4,TSH,CTP score
Abstract
Cirrhosis of liver is a leading cause of morbidity and mortality worldwide. Liver plays a vital role in thyroid hormone metabolism and circulation of thyroid hormones by producing thyroid binding globulin. The liver plays a crucial role in the thyroid hormone synthesis, as it is the most important organ in the extrathyroidal conversion of T4 to T3 by Type 1 deiodinase. With this background, this study is aimed to assess the thyroid function in patients with cirrhosis of liver and correlate the levels of thyroid hormone with the severity of the disease.
Aim: To study the thyroid hormone levels (FT3, FT4, TSH) in patients with cirrhosis of liver and assess the relation of thyroid hormone levels with severity of liver disease.
Material and methods: The study was conducted at Krishna Institute Of Medical Sciences from February 2021 to August 2022 on 97 patients chosen as study subjects. Patients who are admitted in wards and intensive care unit at Krishna hospital were included in the study. All the patients were diagnosed with cirrhosis of liver based on case history, initial clinical evaluation, haematological, biochemical and radiological investigations and were enrolled into the study after applying the exclusion criteria. The severity of liver cirrhosis was determined based on the Child-Turcotte-Pugh grading system. Thyroid function tests (FT3, FT4, TSH) were done.Data was recorded in Microsoft Excel programme and statistical analysis was performed by the SPSS program for Windows, version 25.
Results: A total of 97 patients with diagnosis of cirrhosis of liver were included in this cross sectional study. On comparing the mean serum levels of T3, T4 and TSH in CTP A, B and C groups, it was found the T3 and T4 were lowest in the CTP Class C group (1.501±0.136, 0.843±0.199 respectively),followed by the CTP Class B group (1.866±0.129, 1.111±0.057 respectively) and the CTP Class A group were (2.462±0.435, 2.276±0.191 respectively).The mean TSH was the highest in the CTP Class C group (5.128 ± 0.274), followed by the Class CTP B group (4.688 ± 0.278) and the CTP A group was (3.787 ± 0.096).
Conclusion: In this present study low levels of FT3 levels, normal levels of FT4 and slightly high levels of TSH were observed. It was observed that there was high negative correlation between FT3 and CTP score, high negative correlation between FT4 and CTP score and high positive correlation between TSH and CTP score . Therefore it can be said that as the severity of the liver cirrhosis
increases, the FT3 and FT4 levels decreases and the TSH level increases.
References
2. Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J. Harrison’s principles of internal medicine 19th Ed. McGraw-Hill Medical; 2014.
3. Kharb S, Garg M, Puri P, Brar KS, Pandit A, Srivastava S. Assessment of thyroid and gonadal function in liver diseases. Indian J Endocrinol Metab. 2015;19(1):89.
4. Arafa M, Besheer T, Elkannishy G, El-hussiny MA, Rakha EB. Features of hormonal disturbances in cirrhotic patients with hepatic encephalopathy. Age (years). 2012;49(5.62):51–38.
5. Sorvillo F, Mazziotti G, Carbone A, Morisco F, Cioffi M, Rotondi M, et al. Increased serum reverse triiodothyronine levels at diagnosis of hepatocellular carcinoma in patients with compensated HCV‐related liver cirrhosis. Clin Endocrinol (Oxf). 2003;58(2):207–12.
6. Kayacetin E, Kisakol G, Kaya A. Low serum total thyroxine and free triiodothyronine in patients with hepatic encephalopathy due to non-alcoholic cirrhosis. Swiss Med Wkly. 2003;133(1314).
7. D’Azzò G, Pinzello G, Pace F, Garofalo P, Craxi A, Janni A. The prognostic value of thyroid function tests in predominantly non-alcoholic cirrhotic patients: a prospective investigation. J Endocrinol Invest. 1985;8(4):331–6.
8. Wasley A, Kruszon-Moran D, Kuhnert W, Simard EP, Finelli L, McQuillan G, et al. The prevalence of hepatitis B virus infection in the United States in the era of vaccination. The Journal of infectious diseases. 2010;202(2):192–201.
9. Punekar P, Sharma AK, Jain A. A study of thyroid dysfunction in cirrhosis of liver and correlation with severity of liver disease. Indian J Endocrinol Metab. 2018;22(5):645.
10. Liu C, Li L, Zeng L. The Clinical Value of Thyroid Hormone Levels and Correlation with Severity of Liver Cirrhosis. Comput Intell Neurosci. 2022 Jun 6;2022:5365172.
11. Deepika G, Veeraiah N, Rao P, Reddy DN. Prevalence of hypothyroidism in Liver Cirrhosis among Indian patients. Int J Pharm Med Res. 2015;3(3):4–7
12. D’costa L, Dhume C. Assessment of thyroid parameters in alcoholic liver disease. Int J Pharm Biosci. 2016;7(4):771–6.
13. El-Sawy AAA, Tawfik MA. Low serum free and total tri-iodothyronine hormones as possible prognostic factors in liver cirrhotic patients because of chronic hepatitis C. Tanta Medical Journal. 2015;43(2):46.
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