[Occult thyroid dysfunction in outpatients with liver cirrhosis]

Several alterations in thyroid function have been identified in patients with liver cirrhosis (LC).

To carry out a thyroid disease screening in adult patients with LC.

A cross-sectional study. Serum levels of thyroid-stimulating hormone (TSH) and free-tetraiodothyronine (T4) were measured, and compared according to etiology of the cirrhosis, sex, model of end-stage liver disease (MELD) score, and Child-Pugh (C-P) class.

The most frequent etiology was hepatitis C virus (45%), followed by non- alcoholic fatty liver-disease (17%). We found thyroid dysfunction in 36% of the patients. The most frequent alteration was subclinical hypothyroidism (34%). Patients with alcohol-induced cirrhosis had the highest frequency of subclinical hypothyroidism (45%) and TSH levels were higher in patients with cirrhosis due to autoimmune disease and in those with alcohol-induced cirrhosis.

We found no correlation between thyroid hormone levels, age, MELD score, or C-P. Our results showed that occult primary thyroid dysfunction is frequent in outpatients with LC, regardless of age, etiology, or liver reserve. Subclinical hypothyroidism was the main alteration and presented more frequently in patients with alcohol-induced cirrhosis. Longitudinal studies are needed to know the impact of subclinical hypothyroidism on the clinical progression of patients with cirrhosis.