Serum Total Triiodothyronine versus Free Tetraiodothyronine and TSH in Patients with HCV Related Cirrhosis and Their Correlation to the Severity of Cirrhosis — Oak Academic Publishing
Research ArticleOpen AccessGoogle Scholar indexed
Serum Total Triiodothyronine versus Free Tetraiodothyronine and TSH in Patients with HCV Related Cirrhosis and Their Correlation to the Severity of Cirrhosis
Internal Medicine Department, Zagazig University, Zagazig, Egypt
,
Tropical Medicine Department, Zagazig University, Zagazig, Egypt
Background and Aim: The levels of thyroid hormones and their binding proteins are altered in patient with cirrhosis. We aim to study the changes in triiodothyronine level in HCV related cirrhosis and its correlation to the severity of liver decompensation. Patients and Methods: This study included seventy two patients with HCV related cirrhosis in three groups Group I: 24 patients with Child A class Group II: 24 patients with Child B and C classes without hepatic encephalopathy Group III: 24 patients with Child B and C classes with hepatic encephalopathy. Results: T3 level was significantly lower in group III than group I and II (0.74 ng/ml vs 1 and 1.3 ng/ml in group II and I in succession). The correlation between Child’s score and T3 level was highly significant (r = -0.64, P < 0.001). Conclusion: Triiodothyronine level is lower in cirrhosis and its level is correlated to the severity of decompensation.
KeywordsFree T4TSHClinical EuthyroidCirrhosisHCV
Iredale, J.P. (2003) Cirrhosis: New Research Provides a Basis for Rational and Targeted Treatments. BMJ, 327, 143-147. http://dx.doi.org/10.1136/bmj.327.7407.143
Puche, J.E., Saiman, Y. and Friedman, S.L. (2013) Hepatic Stellate Cells and Liver Fibrosis. Comprehensive Physiology, 3, 1473-1492. http://dx.doi.org/10.1002/cphy.c120035
Hennemann, G., Docter, R., Friesema, E.C., de Jong, M., Krenning, E.P. and Visser, T.J. (2001) Plasma Membrane Transport of Thyroid Hormones and Its Role in Thyroid Hormone Metabolism and Bioavailability. Endocrine Reviews, 22, 451-476. http://dx.doi.org/10.1210/edrv.22.4.0435
Mendel, C.M., Cavalieri, R.R. and Weisiger, R.A. (1988) Uptake of Thyroxine by the Perfused Rat Liver: Implications for the Free Hormone Hypothesis. The American Journal of Physiology, 255, E110-E119.
Bianco, A.C., Salvatore, D., Gereben, B., Berry, M.J. and Larsen, P.R. (2002) Biochemistry, Cellular and Molecular Biology, and Physiological Roles of the Iodothyronine Selenodeiodinases. Endocrine Reviews, 23, 38-89. http://dx.doi.org/10.1210/edrv.23.1.0455
Mansour-Ghanaei, F., Mehrdad, M., Mortazavi, S., Joukar, F., Khak, M. and Atrkar-Roushan, Z. (2012) Decreased Serum Total T3 Level in Hepatitis B and C Related Cirrhosis by Severity of Liver Damage. Annals of Hepatology, 11, 667-671.
Bianchi, G.P., Zoli, M., Marchesini, G., Volta, U., Vecchi, F., Iervese, T., Bonazzi, C. and Pisi, E. (1991) Thyroid Gland Size and Function in Patients with Cirrhosis of the Liver. Liver, 11, 71-77. http://dx.doi.org/10.1111/j.1600-0676.1991.tb00495.x
Malik, R. and Hodgson, H. (2002) The Relationship between the Thyroid Gland and the Liver. QJM, 95, 559-569. http://dx.doi.org/10.1093/qjmed/95.9.559
Oren, R., Sikuler, E., Wong, F., Blendis, L.M. and Halpern, Z. (2000) The Effects of Hypothyroidism on Liver Status of Cirrhotic Patients. Journal of Clinical Gastroenterology, 31, 162-163. http://dx.doi.org/10.1097/00004836-200009000-00016
Oren, R., Brill, S., Dotan, I. and Halpern, Z. (1998) Liver Function in Cirrhotic Patients in the Euthyroid versus the Hypothyroid State. Journal of Clinical Gastroenterology, 27, 339-341. http://dx.doi.org/10.1097/00004836-199812000-00012
Mohamed, M.K. (2005) Epidemiology of HCV in Egypt. The Afro-Arab Liver Journal, 3, 41-52.
Child, C.G. and Turcotte, J.G. (1964) Surgery and Portal Hypertension. In: Child. C.G., Ed., The Liver and Portal Hypertension, Saunders, Philadelphia, 50-64.
Kayacetin, E., Kisakol, G. and Kaya, A. (2003) Low Serum Total Thyroxine and Free Triiodothyronine in Patients with Hepatic Encephalopathy Due to Non-Alcoholic Cirrhosis. Swiss Medical Weekly, 133, 210-213.
Yamanaka, T., Ido, K., Kimura, K. and Saito, T. (1980) Serum Levels of Thyroid Hormones in Liver Diseases. Clinica Chimica Acta, 101, 45-55.
Borzio, M., Caldara, R., Borzio, F., Piepoli, V., Rampini, P. and Ferrari, C. (1983) Thyroid Function Tests in Chronic Liver Disease: Evidence for Multiple Abnormalities Despite Clinical Euthyroidism. Gut, 24, 631-636. http://dx.doi.org/10.1136/gut.24.7.631
Shimada, T., Higashi, K., Umeda, T. and Sato, T. (1988) Thyroid Functions in Patients with Various Chronic Liver Diseases. Endocrinologia Japonica, 35, 357-369. http://dx.doi.org/10.1507/endocrj1954.35.357
Agha, F., Qureshi, H. and Khan, R.A. (1989) Serum Thyroid Hormone Levels in Liver Cirrhosis. Journal of Pakistan Medical Association, 39, 179-183.
Antonelli, A., Ferri, C., Fallahi, P., Ferrari, S.M., Ghinoi, A., Rotondi, M. and Ferrannini, E. (2006) Thyroid Disorders in Chronic Hepatitis C. The American Journal of Medicine, 117, 10-13.
Spadaro, L., Bolognesi, M., Pierobon, A., Bombonato, G., Gatta, A. and Sacerdoti, D. (2004) Alterations in Thyroid Doppler Arterial Resistance Indices, Volume and Hormones in Cirrhosis: Relationships with Splanchnic Haemodynamics. Ultrasound in Medicine and Biology, 30, 19-25. http://dx.doi.org/10.1016/j.ultrasmedbio.2003.10.008
El-Kabbany, Z.A., Hamza, R.T., Abd El Hakim, A.S. and Tawfik, L.M. (2012) Thyroid and Hepatic Haemodynamic Alterations among Egyptian Children with Liver Cirrhosis. ISRN Gastroenterol, 2012, 595734. http://dx.doi.org/10.5402/2012/595734
Dehghani, S.M., Haghighat, M., Eghbali, F., Karamifar, H., Malekpour, A., Imanieh, M.H. and Malek-Hoseini, S.A. (2013) Thyroid Hormone Levels in Children with Liver Cirrhosis Awaiting a Liver Transplant. Experimental and Clinical Transplantation, 11, 150-153. http://dx.doi.org/10.6002/ect.2012.0182
Novis, M., Vaisman, M. and Coelho, H.S. (2001) Thyroid Function Tests in Viral Chronic Hepatitis. Arquivos De Gastroenterologia, 38, 254-260.
Tas, A., Koklü, S., Beyazit, Y., Kurt, M., Sayilir, A., Yesil, Y. and Celik, H. (2012) Thyroid Hormone Levels Predict Mortality in Intensive Care Patients with Cirrhosis. The American Journal of the Medical Sciences, 344, 175-179. http://dx.doi.org/10.1097/MAJ.0b013e318239a666
Aizawa, T., Yamada, T., Tawata, M., Shimizu, T., Furuta, S., Kiyosawa, K. and Yakata, M. (1980) Thyroid Hormone Metabolism in Patients with Liver Cirrhosis, as Judged by Urinary Excretion of Triiodothyronine. Journal of the American Geriatrics Society, 28, 485-491. http://dx.doi.org/10.1111/j.1532-5415.1980.tb01126.x
Schlienger, J.L., Jacques, C., Sapin, R. and Stephan, F. (1980) Thyroid Function in Patients with Alcoholic Cirrhosis. Ann Endocrinol (Paris), 41, 81-94.
Atalay, R., Ersoy, R., Demirezer, A.B., Akin, F.E., Polat, S.B., Cakir, B. and Ersoy, O. (2015) Day-Night Variations in Thyroid Stimulating Hor-mone and Its Relation with Clinical Status and Metabolic Parameters in Patients with Cirrhosis of the Liver. Endocrine, 48, 942-948. http://dx.doi.org/10.1007/s12020-014-0364-1
Hamblin, P.S., Dyer, S.A., Mohr, V.S., Le Grand, B.A., Lim, C.F., Tuxen, D.V., Topliss, D.J. and Stockigt, J.R. (1986) Relationship between Thyrotropin and Thyroxine Changes during Recovery from Severe Hypothyroxinemia of Critical Illness. The Journal of Clinical Endocrinology & Metabolism, 62, 717-722. http://dx.doi.org/10.1210/jcem-62-4-717
Fliers, E., Bianco, A.C., Langouche, L. and Boelen, A. (2015) Thyroid Function in Critically Ill Patients. The Lancet Diabetes & Endocrinology, 3, 816-825. http://dx.doi.org/10.1016/S2213-8587(15)00225-9