Importance of thyroid-stimulating hormone levels in liver disease

Kim, Hyun Jin

doi:10.1515/jpem-2020-0031

Cited by 5 publications

(7 citation statements)

References 25 publications

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“…One scholar confirmed our findings of higher bilirubin levels in SCH subjects. He additionally reported lower albumin levels, a finding which we observed in subjects with TSH in the 6.5-8 mIU/L range [28].…”

Section: Discussionsupporting

confidence: 67%

“…The findings of elevated bilirubin, low albumin, high globulin, and high AST in the TSH range of 6.5-8 mIU/L suggest that thyroid dysfunction in this range of TSH profoundly induces impairment in lipid metabolism. This in turn results in steatogenic changes by the various mechanisms discussed previously, thus precipitating and/or potentiating hepatic injury [28]. In some cases, cholestatic jaundice coincident with hypothyroidism has been ascribed to the impairment in bilirubin and bile excretion, which is secondary to the hepatic injury.…”

Section: Discussionmentioning

confidence: 98%

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Association of TSH Levels in the Therapeutically Neglected Range of 6.5–8 mIU/L with Significant Changes in Liver and Kidney Function: A Retrospective Study of the Kashmiri Population

Ahmed

Aziz

2022

SJMS

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Background: The thyroid gland secretes hormones crucial for growth, differentiation, regulation of metabolic processes, and homeostasis. In response to underactivity of this gland, the pituitary secretes thyrotropin, also known as the thyroid-stimulating hormone (TSH). Medication for thyroid hypofunction is usually started when TSH levels exceed 10 mIU/L. However, we hypothesize that TSH levels much below this therapeutic threshold level may herald significant renal and hepatic dysfunction. The present study was thus conducted to assess liver and kidney function parameters in cases having TSH in the subclinical range with particular focus on the therapeutically neglected (6.5–8 mIU/L) range. Methods: Hospital laboratory archives of 297 adults with laboratory evidence of hypothyroidism, that is, TSH > 6.5 mIU/L, were retrieved and compared with data obtained from 430 euthyroid hospital controls, that is, TSH < 2.5 mIU/L, also from the same period. The thyroid profile and clinical chemistry analyses were performed on Beckman Coulter’s UniCel DxI 800 and AU 5800, respectively. SPSS version 20 was used to analyze the results. Results: Significant differences in triiodothyronine (T3), thyroxine (T4), TSH, urea, creatinine, total bilirubin, total protein (TP), and liver enzymes were observed between cases with TSH > 6.5 mIU/L and controls (P < 0.05). There was also a significant difference in T4, TSH, urea, creatinine, total bilirubin, albumin and aspartate aminotransferase (AST) among cases with TSH in the range of 6.5–8 mIU/L when compared with controls (P < 0.05). A correlation of T3 with TSH, urea, and creatinine was seen (P < 0.05). No correlations between TSH and other clinical chemistry parameters could be observed. However, in the 6.5–8 mIU/L subgroup, correlation of TSH was seen with TP and albumin only. Conclusion: Authors found that, as a rule, subtle renal and hepatic dysfunction were established in cases with TSH levels <8 mIU/L, which was below the typical “therapeutic cut-off” of 10 mIU/L. Accordingly, we advocate against incautiousness and suggest regular monitoring, especially in the 6.5–8 mIU/L range.

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Section: Discussionsupporting

confidence: 67%

Section: Discussionmentioning

confidence: 98%

Association of TSH Levels in the Therapeutically Neglected Range of 6.5–8 mIU/L with Significant Changes in Liver and Kidney Function: A Retrospective Study of the Kashmiri Population

Ahmed

Aziz

2022

SJMS

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“…In our model, the presence of hepatic steatosis, serum aspartate-aminotransferase levels, ferritin levels, but also serum glucose, lipase, and triglycerides appear to be relevant predictors. While an association of liver and thyroid disease has been examined for a long time, it is still under debate if this correlation is independent of the metabolic syndrome or can be fully explained by alterations in glucose and lipid metabolism [ 34 – 37 ].…”

Section: Resultsmentioning

confidence: 99%

Analysis of epidemiological association patterns of serum thyrotropin by combining random forests and Bayesian networks

et al. 2022

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Background Approaching epidemiological data with flexible machine learning algorithms is of great value for understanding disease-specific association patterns. However, it can be difficult to correctly extract and understand those patterns due to the lack of model interpretability. Method We here propose a machine learning workflow that combines random forests with Bayesian network surrogate models to allow for a deeper level of interpretation of complex association patterns. We first evaluate the proposed workflow on synthetic data. We then apply it to data from the large population-based Study of Health in Pomerania (SHIP). Based on this combination, we discover and interpret broad patterns of individual serum TSH concentrations, an important marker of thyroid functionality. Results Evaluations using simulated data show that feature associations can be correctly recovered by combining random forests and Bayesian networks. The presented model achieves predictive accuracy that is similar to state-of-the-art models (root mean square error of 0.66, mean absolute error of 0.55, coefficient of determination of R2 = 0.15). We identify 62 relevant features from the final random forest model, ranging from general health variables over dietary and genetic factors to physiological, hematological and hemostasis parameters. The Bayesian network model is used to put these features into context and make the black-box random forest model more understandable. Conclusion We demonstrate that the combination of random forest and Bayesian network analysis is helpful to reveal and interpret broad association patterns of individual TSH concentrations. The discovered patterns are in line with state-of-the-art literature. They may be useful for future thyroid research and improved dosing of therapeutics.

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“…El Feki and Abdalla (20) reached similar conclusions. According to Punekar et al and (27,28) research, patients with cirrhosis had considerably higher TSH levels. Our findings agree with those of these investigations.…”

Section: Discussionmentioning

confidence: 93%

Thyroid Function in Liver Cirrhosis: Is It affected? A Case Control Study

Gameel

Elbialy²

2023

The Egyptian Journal of Hospital Medicine

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Background: Cirrhosis of the liver may be compensated with no obvious complications or decompensated which accompanied by ascites, hematemesis, or renal impairment. Liver disease affects thyroid hormone metabolism, thyroid problems can impair liver functions, and several systemic diseases can affect both organs. Objectives: The aim of the current work was to study level of thyroid hormones in patients with liver cirrhosis and to evaluate the significance of thyroid hormone level and severity of liver cirrhosis. Patients and methods: This case control study included a total of 25 cirrhotic patients and equal number of age and gender matched controls, attending at

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Importance of thyroid-stimulating hormone levels in liver disease

Cited by 5 publications

References 25 publications

Association of TSH Levels in the Therapeutically Neglected Range of 6.5–8 mIU/L with Significant Changes in Liver and Kidney Function: A Retrospective Study of the Kashmiri Population

Association of TSH Levels in the Therapeutically Neglected Range of 6.5–8 mIU/L with Significant Changes in Liver and Kidney Function: A Retrospective Study of the Kashmiri Population

Analysis of epidemiological association patterns of serum thyrotropin by combining random forests and Bayesian networks

Thyroid Function in Liver Cirrhosis: Is It affected? A Case Control Study

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