Risk factors of hyperthyroidism with hepatic function injury: a 4-year retrospective study

Hepatic function injury is one of the common complications of hyperthyroidism (mainly Graves' disease), which affects the choice of treatment and the curative rate. Our goal was to describe clinical and biochemical patterns in patients suffering from Graves' disease (GD) and hepatic function injury and to determine the influential factors. A cohort of 1 070 patients who received (131)I treatment were studied. Many examinations were performed before (131)I therapy, such as: the 24-h radioactive iodine uptake of thyroid (RAIU(24 h)) and serum-free triiodothyronine (FT(3)), free thyroxine (FT(4)), sensitive thyroid-stimulating hormone (sTSH), antithyrotrophin receptor antibody (TRAb), thyroglobulin antibody (TgAb), and antithyroid peroxidase antibody (TPOAb), serum hepatic function tests, etc. Data were analyzed by the unpaired t-test, the independent samples t-test, the χ(2) test, logistic regression, and Pearson bivariate correlation. Age, course of GD, thyroid's weight, FT(4), TPOAb, and TRAb in GD patients with hepatic function injury were higher than those with normal hepatic function patients. The influential factors were age, hyperthyroidism duration, heart rate, thyroid's weight, FT(4), RAIU(24 h), TgAb, TPOAb, and TRAb. RAIU(24 h) was the protecting factor. Age, course of GD, heart rate, thyroid's weight, FT(4), TRAb, and TPOAb were the risk factors. Patients whose age was higher than 45 years old, heart rate above 90 bpm, thyroid weight more than 35 g, the hyperthyroidism duration more than 3 years, FT(4) higher than 70.5 pmol/l, the level of TPOAb above 360 IU/ml, and the level of TRAb above 15 IU/l have increased risk of hepatic function injury. As treatment (131)I therapy was found to be the best choice.