Incidence of abnormal liver biochemical tests in hyperthyroidism

Area of Science:

• Endocrinology
• Hepatology
• Internal Medicine

Background:

• Abnormal serum liver function tests are frequently observed in patients with untreated thyrotoxicosis.
• The incidence of these abnormalities varies across published literature.
• Antithyroidal medications may exacerbate pre-existing abnormal liver biochemistries.

Purpose of the Study:

• To identify risk factors associated with abnormal liver biochemical tests in new-onset thyrotoxicosis.
• To determine the threshold of thyrotoxicosis severity linked to abnormal liver function.
• To assess the incidence of liver test abnormalities in untreated thyrotoxicosis.

Main Methods:

• Retrospective cohort study of 1514 adult patients diagnosed with thyrotoxicosis between 2002-2016.
• Inclusion criteria: serum TSH <0.3 mIU/l or thyrotoxicosis ICD-9 code, confirmed hyperthyroidism, and available liver function tests.
• Assessed liver tests included AST, ALT, AP, GGT, total bilirubin, and conjugated bilirubin.

Main Results:

• Overall incidence of any abnormal liver biochemical test within six months of thyrotoxicosis diagnosis was 39%.
• Significant predictors for abnormal liver tests included initial serum TSH <0.02 mIU/l, male gender, and African-American race.
• These factors were associated with abnormalities within six months of new-onset, untreated thyrotoxicosis diagnosis.

Conclusions:

• This study identified key risk factors for developing abnormal liver biochemical tests in patients with new-onset thyrotoxicosis.
• Low TSH levels, male sex, and African-American ethnicity are associated with increased risk.
• Findings aid in predicting and managing liver function abnormalities in thyrotoxicosis patients.