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Liver cirrhosis and thyroid function: Friend or foe?

Stefanie Vincken1, Hendrik Reynaert2, Johan Schiettecatte3

  • 1a Department of Internal Medicine , Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel , Brussels , Belgium.

Acta Clinica Belgica
|August 25, 2016
PubMed
Summary
This summary is machine-generated.

Patients with liver cirrhosis show lower thyroid hormone levels, specifically free triiodothyronine (fT3) and free thyroxine (fT4), compared to healthy individuals. These thyroid function changes correlate with liver disease severity, suggesting potential non-thyroidal illness syndrome.

Keywords:
Liver cirrhosisThyroid function tests

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Area of Science:

  • Endocrinology
  • Hepatology
  • Internal Medicine

Background:

  • The liver is crucial for thyroid hormone metabolism, transport, and clearance.
  • Thyroid and liver health are interdependent for maintaining hormonal balance.
  • Limited data exists on thyroid function in liver cirrhosis patients.

Purpose of the Study:

  • To assess thyroid hormone levels in stable liver cirrhosis patients.
  • To compare thyroid function between cirrhosis patients and healthy controls.
  • To investigate correlations between liver function tests and thyroid parameters, including autoimmunity.

Main Methods:

  • Prospective case-control study involving 29 cirrhosis patients and 50 healthy controls.
  • Exclusion of participants with confounding factors affecting thyroid function.
  • Measurement of serum TSH, fT3, fT4, and TPO-Ab, with correlation analysis against liver function tests (AST, ALT, AP, GGT, INR, bilirubin, albumin) and Child-Pugh score.

Main Results:

  • Significantly lower fT3 and fT4 levels were observed in cirrhosis patients compared to controls (p=0.001 and 0.002).
  • No significant difference in TSH levels between the groups.
  • No increased prevalence of thyroid autoimmunity (TPO-Ab) in cirrhosis patients.
  • Negative correlation between fT3 levels and Child-Pugh score.

Conclusions:

  • Cirrhosis patients exhibit reduced fT3 and fT4 levels with normal TSH, potentially indicating acquired central hypothyroidism consistent with non-thyroidal illness syndrome (NTIS).
  • fT3 levels correlate negatively with liver dysfunction severity (Child-Pugh score).
  • Thyroid autoimmunity is not more prevalent in this cohort of cirrhosis patients.