Thyroid function tests in chronic liver disease: evidence for multiple abnormalities despite clinical euthyroidism.

Borzio, Mauro; Caldara, Roberto; Borzio, Franco; Piepoli, V; Rampini, P.; Ferrari, C

doi:10.1136/gut.24.7.631

Cited by 75 publications

(54 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…8,[10][11][12][13] Our findings revealed no correlation between the amount of T3 and the severity of the hepatic disease. We observed that mean PELD/MELD and Child scores were higher in children with low T3 levels, but this was not significant (P = .14, and P = .11).…”

Section: Discussioncontrasting

confidence: 37%

“…The liver is the site of synthesis and degradation of carrier proteins (ie, thyroxin binding globulin, thyroxin-binding prealbumin, and albumin) and is a major site of peripheral conversion, degradation, and excretion of thyroid hormones. 10,11 Thyroid abnormalities have been reported in acute and chronic liver diseases, and thyroid hormone levels have been evaluated with all the clinically available indices, confirming the existence of several abnormalities in thyroid function tests in both cirrhosis and chronic liver diseases, as shown in this study. 12,13 Circulating thyroid hormone levels may range from normal values 14 to the marked abnormalities seen in the "euthyroid sick syndrome."…”

Section: Discussionmentioning

confidence: 72%

See 1 more Smart Citation

Thyroid Hormone Levels in Children With Liver Cirrhosis Awaiting a Liver Transplant

Dehghani

Haghighat²,

Eghbali³

et al. 2013

Exp Clin Transplant

View full text Add to dashboard Cite

Objectives: Evidence exists that decreased in triiodothyronine (T3) and thyroxine (T4) levels are associated with the severity of liver disease, and these hormones could be used as disease prognostic factors, but there are paradoxes in this regard in the literature. This study aimed at evaluating the correlation between thyroid hormone levels and severity of liver disease. Materials and Methods:We measured thyroid hormone levels in 83 children with liver cirrhosis using radioimmunoassay techniques. Results: Four patients (4.8%) showed a decrease in the amount of T3 and 9 patients (10.8%) revealed increased levels of T3. Also, decreases were seen in the T4 levels of 7 patients (8.4%), and 4 patients (4.8%) showed increases in levels of T4. The serum albumin levels were lower and international normalized ratio was higher in patients with low T3 and low T4. This study reveals that the Model for End-Stage Liver Disease and Pediatric End-Stage Liver Disease scores are statistically related to the decreased amounts of T4 (P = .036). The Model for End-Stage Liver Disease and Pediatric End-Stage Liver Disease scores and the Child scores were higher in low T3 patients, but this was not significant (P > .05). Conclusions: Decreased levels of thyroid hormones are correlated with the severity of disease and can be seen in more advanced cirrhosis. Patients with decreased T4 levels need a liver transplant more immediately than those patients that do not have decreased T4 levels.

show abstract

Section: Discussioncontrasting

confidence: 37%

Section: Discussionmentioning

confidence: 72%

Thyroid Hormone Levels in Children With Liver Cirrhosis Awaiting a Liver Transplant

Dehghani

Haghighat²,

Eghbali³

et al. 2013

Exp Clin Transplant

View full text Add to dashboard Cite

show abstract

“…Previous studies have suggested TT3 and TT4 increases in chronic liver disease, commensurate with severity of liver dysfunction due to high TBG, and that TT3 and TT4 serum levels were reduced in liver cirrhosis [25,26].…”

Section: Discussionmentioning

confidence: 99%

Thyroid disturbance related to chronic hepatitis C infection: role of CXCL10

et al. 2013

View full text Add to dashboard Cite

The associaTion between chronic hepatitis C (HCV) infection and thyroid autoimmune disorders (AITD) is controversial, but may occur or worsen during alpha-interferon treatment [1]. A large study observed slightly increased risk for thyroiditis in HCV-infected patients (hazard ratio = 1.06, 95% CI = 1.01-1.11) [2] and a recent review suggested a weak association in comparisons to hepatitis B (HBV) infected and control populations (odds ratio = 1.6, 95% CI=1.4-1.9). The authors suggested that differences in geographical distribution, genetic variability and environmental cofactors abstract. Association between autoimmune thyroid diseases (AITD) and hepatitis C is controversial, but may occur or worsen during alpha-interferon treatment. The mechanism responsible for autoimmune diseases in infected patients has not been fully elucidated. This study aims to evaluate the frequency of AITD in chronic hepatitis C and the association of chemokine (CXC motif) ligand 10 (CXCL10) and AITD. One hundred and three patients with chronic hepatitis C and 96 controls were prospectively selected to clinical, hormonal, thyroid autoimmunity and ultrasound exams, besides thyroxinebinding globulin (TBG) and CXCL10 measurements and hepatic biopsies. The frequency of AITD among infected subjects was similar to controls. TT3 and TT4 distributions were right shifted, as was TBG, which correlated to both of them. Thyroid heterogeneity and hypoechogenicity were associated with AITD. Increased vascularization was more prevalent in chronic hepatitis C.CXCL10 was higher in infected patients (p=0.007) but was not related to thyroid dysfunction. Increase in CXCL10 levels were consistent with hepatic necroinflammatory activity (p=0.011). In summary, no association was found between chronic hepatitis C and AITD. Infected subjects had higher TT3 and TT4 which were correlated to TBG. Increased CXCL10 was not associated to thyroid dysfunction in HCV-infected population.

show abstract

“…Thyroid hormones are essential for normal basal metabolic rate regulation of all cells, including hepatocytes (1,9,10) . The liver plays an important role in maintaining thyroid hormone homeostasis.…”

Section: Introductionmentioning

confidence: 99%

“…The liver plays an important role in maintaining thyroid hormone homeostasis. It synthesizes and secretes the thyroid hormone-binding proteins and it is the principal organ responsible for the conversion of thyroxine (T4) to triiodothyronine (T3), accounting for 80% of the T3 produced daily from T4 (1,6,8,9,19) . T4 is a prohormone and the main secretory product of the thyroid and T3 is the biologically active form of thyroid hormone.…”

Section: Introductionmentioning

confidence: 99%

The Influence of End-Stage Liver Disease and Liver Transplantation on Thyroid Hormones

Penteado

Coelho

Parolin

et al. 2015

Arq. Gastroenterol.

View full text Add to dashboard Cite

-Background -Thyroid dysfunction has been reported in most chronic illnesses including severe liver disease. These defects in thyroid hormone metabolism result in the sick euthyroid syndrome, also known as low T3 syndrome. Objectives -Our objective was to evaluate the thyroid function in patients with end stage liver disease prior and after deceased donor liver transplantation and to correlate thyroid hormonal changes with the MELD score (Model for End stage Liver Disease). Methods -In a prospective study, serum levels of thyrotropin (thyroid stimulating hormone -TSH), total thyroxine (tT4), free thyroxine (fT4) and triiodothyronine (T3) from 30 male adult patients with end stage liver disease were measured two to four hours before and 6 months after liver transplantation (LT). MELD was determined on the day of transplant. For this analysis, extra points were not added for patients with hepatocellular carcinoma. Results -The patients had normal TSH and fT4 levels before LT and there was no change after the procedure. Total thyroxine and triiodothyronine were within the normal range before LT, except for four patients (13.3%) whose values were lower. Both hormones increased to normal values in all four patients after LT (P=0.02 and P<0.001, respectively). When the patients were divided into two groups (MELD <18 and MELD >18), it was observed that there was no change in the TSH, freeT4, and total T4 levels in both groups after LT. Although there was no significant variation in the level of T3 in MELD <18 group (P=0.055), there was an increase in the MELD >18 group after LT (P=0.003).Conclusion -Patients with end stage liver disease subjected to liver transplantation had normal TSH and fT4 levels before and after LT. In a few patients with lower tT4 and T3 levels before LT, the level of these hormones increased to normal after LT. HEADINGS -Liver transplantation. Thyrotropin. Thyroxine. Triiodothyronine. Liver cirrhosis. End stage liver disease. Euthyroid sick syndromes.

show abstract

Thyroid function tests in chronic liver disease: evidence for multiple abnormalities despite clinical euthyroidism.

Cited by 75 publications

References 20 publications

Thyroid Hormone Levels in Children With Liver Cirrhosis Awaiting a Liver Transplant

Thyroid Hormone Levels in Children With Liver Cirrhosis Awaiting a Liver Transplant

Thyroid disturbance related to chronic hepatitis C infection: role of CXCL10

The Influence of End-Stage Liver Disease and Liver Transplantation on Thyroid Hormones

Contact Info

Product

Resources

About