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Plasma isocitrate dehydrogenase as a marker of centrilobular hepatic necrosis in patients with hyperthyroidism
Y H Chung1, S A Jung, B C Song
1Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Insights
Plasma Isocitrate dehydrogenase (ICDH) levels and ICDH/ALT ratios are elevated in hyperthyroidism patients, suggesting ICDH may help monitor liver necrosis. This finding aids in distinguishing liver injury types.
Area of Science:
- Biochemistry
- Hepatology
- Endocrinology
Background:
- Liver injury can manifest as centrilobular or periportal necrosis.
- Isocitrate dehydrogenase (ICDH) has shown potential in differentiating these patterns in animal models.
- Hyperthyroidism can be associated with liver dysfunction.
Purpose of the Study:
- To evaluate plasma ICDH as a marker for centrilobular necrosis in hyperthyroid patients.
- To compare ICDH and alanine aminotransferase (ALT) levels in hyperthyroidism, chronic viral hepatitis (CVH), and controls.
- To assess the utility of the ICDH/ALT ratio in diagnosing liver injury in hyperthyroidism.
Main Methods:
- Measured plasma ICDH and ALT activities in 56 hyperthyroid patients, 16 CVH patients, and 17 controls.
- Analyzed differences in enzyme levels and ratios between groups.
- Correlated ICDH and ALT levels within patient cohorts.
Main Results:
- Plasma ICDH levels were significantly higher in hyperthyroid patients compared to CVH patients and controls (p < 0.01 and p < 0.001).
- ALT levels were higher in CVH patients than in hyperthyroid patients (p < 0.01).
- The ICDH/ALT ratio was significantly higher in hyperthyroid patients than in CVH patients (p < 0.0001).
- ICDH levels decreased to normal as thyroid function and ALT normalized in a hyperthyroid patient.
Conclusions:
- Plasma ICDH and the ICDH/ALT ratio may serve as valuable biomarkers for identifying and monitoring hepatic necrosis in hyperthyroidism.
- These markers could aid in differentiating centrilobular from periportal necrosis.
- Further research is warranted to confirm these findings in larger patient cohorts.
Abstract:
Isocitrate dehydrogenase (ICDH) may be useful for differentiating centrilobular from periportal necrosis in rats with liver injury. In this study, we assessed the usefulness of ICDH as a marker of centrilobular necrosis in patients with hyperthyroidism. Isocitrate dehydrogenase and alanine aminotransferase (ALT) activities were measured in the plasma of 56 patients with hyperthyroidism, 16 patients with chronic viral hepatitis (CVH), and 17 controls. Isocitrate dehydrogenase levels were higher in patients with hyperthyroidism than in those with CVH or in the controls (p < 0.01 and p < 0.001, respectively), even though ALT levels were higher in patients with CVH than in patients with hyperthyroidism (p < 0.01). Isocitrate dehydrogenase/ALT ratios were also higher in patients with hyperthyroidism than in those with CVH (p < 0.0001). Isocitrate dehydrogenase correlated to ALT levels in patients with hyperthyroidism or CVH (p < 0.05). In a patient with hyperthyroidism, ICDH levels decreased progressively to normal, and the ALT level and thyroid function were normalized. Thus, the plasma ICDH or ICDH/ALT ratio might be useful for differentiating centrilobular from periportal necrosis and for monitoring the degree of hepatic necrosis in patients with hyperthyroidism.