A STUDY ON EVALUATION OF THYROID FUNCTION TEST IN CHRONIC LIVER DISEASE PATIENTS ATTENDING A TERTIARY CARE HOSPITAL
Main Article Content
Keywords
Child-Pugh Score, Thyroid profile, Chronic liver disease
Abstract
Liver diseases can have various associated endocrine disturbances. The liver plays crucial role in thyroid hormones metabolism through conjugation, excretion, peripheral de-iodination, and production of thyroxine-binding globulin (TBG). Liver dysfunction can result from changes in thyroid function, and distinct liver conditions can have different impacts on the metabolism of thyroid hormones. This study aims to assess the severity of liver dysfunction in relation with thyroid functions in patients with CLD attending a tertiary care hospital.
MATERIALS AND METHODS: This hospital based Cross-sectional study was conducted among 100 patients in the Department of General Medicine for one year at a tertiary care centre. A full history, including history of coronary artery disease, hypo-or hyperthyroidism therapy in the past, and chronic renal illness among patients and attendees. Basic laboratory tests were performed, such as a complete blood picture, Liver function test, PT/INR, Renal function test, Abdominal ultra sonography, and Thyroid function test with serum free T3,Total T3, freeT4, Total T4 and TSH measurements.
RESULT: The majority of patients belonged to the group of 31-40 years, with 29%. Among 100 patients. 76% are Males and 24%are Females, with more prevalence in males than females. 24 cases (24%) were Child-Pugh class A, 45 cases (45%) were Child-Pugh class B, and 31 cases (31%) were Child-Pugh class C. In our study it was observed that as liver disease progresses, as reflected in higher Child-Pugh scores, Total T3, Total T4, free T3 and free T4 levels decreased and TSH levels increased.
CONCLUSION: The findings of the study highlight the importance of regular thyroid function monitoring in assessing and managing CLD patients. Additionally, the significant gender disparities observed in disease severity emphasize the need for gender-specific approaches in CLD management. These insights can guide more effective clinical interventions and improve patient out comes in chronic liver disease.
References
2. Maheshwari A, Thuluvath PJ. Endocrine diseases and the liver. Clin Liver Dis. 2011;15(1):55–67.
3. Zietz B, Lock G, Plach B, Drobnik W, Grossmann J, Scholmerich J, et al. Dysfunction of the hypothalamic-pituitary-glandular axes and relation to Child-Pugh classification in male patients with alcoholic and virus-related cirrhosis. Eur J Gastroenterol Hepatol.2003;15(5):495–501.
4.Borzio M, Caldara R, Borzio F, Piepoli V, Rampini P, Ferrari C. Thyroid function tests in chronic liver disease: evidence for multiple abnormalities despite clinical euthyroidism. Gut. 1983;24(7):631–6.
5.Peng Y, Qi X, Guo X. Child-Pugh Versus MELD Score for the Assessment of Prognosis in Liver Cirrhosis: A Systematic Review and Meta-Analysis of Observational Studies. Medicine (Baltimore). 2016;95(8):e2877.
6. Hartl L, Simbrunner B, Jachs M, Wolf P, Bauer DJM, Scheiner B, et al. Lower free triiodothyronine(fT3) levels in cirrhosis are linked to systemic inflammation, higher risk of acute-on-chronic liver failure, and mortality. JHEPReports. 2024;6(1):100954.
7.Kharb S, Garg MK, Puri P, Brar KS, Pandit A, Srivastava S. Assessment of thyroid and gonadal function in liver diseases. Indian J Endocrinol Metab. 2015;19(1):89–94.
8.Targher G, Montagnana M, Salvagno G, Moghetti P, Zoppini G, Muggeo M, et al. AssociationbetweenserumTSH,freeT4andserumliverenzymeactivitiesina largecohortofunselectedoutpatients.ClinEndocrinol(Oxf).2008;68(3):481–4.
9.Bernardi M, De Palma R, Trevisani F, Pesa O, Tamè MR, Bellanova B, et al. “Low T3 syndrome” in cirrhosis: effect of beta-blockade. Am J Gastroenterol. 1989;84(7):727–31
10.LJJ,SolomonRT,SelviCK Thyroid Dysfunction in Patients with Liver Cirrhosis.IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN. 2017;16(4):18– 22.
11.KayacetinE, KisakolG, KayaA .Low serum total thyroxine and free tri iodo thyronine in patients with hepatic encephalopathy due to non-alcoholic cirrhosis. SwissMedWkly.2003;133(13–14):210–3.
12.Huang X,Jiang S,Fan X,JiangY,WuL,Li F,etal. Low-free tri iodo thyronine is associated with poor prognosis of portal hypertension in cirrhosis. Eur J Gastroenterol Hepatol. 2020;32(10):1358–63
13.Mobin A, Haroon H, Shaikh H, Qureshi F, Ali M. DECOMPENSATED CIRRHOSIS;THYROID HORMONE LEVELS IN PATIENTS. The Professional Medical Journal.2016;23(01):34–8.
14. Deepika G, Veeraiah N, Rao PN, Reddy D. Prevalence of hypothyroidism in Liver Cirrhosis among Indian patients. 2015.
15.Borzio M, Caldara R, Borzio F, Piepoli V, Rampini P, Ferrari C. Thyroid function tests in chronic liver disease: evidence for multiple abnormalities despite clinical euthyroidism. Gut. 1983;24(7):631–6.
16.Patira NK, SalgiyaN, AgrawalD. Correlation of thyroid function test with severity of liver dysfunction in cirrhosis of liver. Journal of Association of Physicians of India. 2019;67(March):51–4.
17.LiuC,LiL,ZengL.The Clinical Value of Thyroid HormoneLevels and Correlation with Severity of Liver Cirrhosis. Comput Intell Neurosci. 2022.
18.PunekarP,SharmaAK,JainA.A study of thyroid dysfunction in cirrhosis of liver and correlation with severity of liver disease. Indian J Endocrinol Metab. 2018;22(5):645–50.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Dr. Shamsheer Khan.P
Associate Professor, Department of General Medicine, Viswabharathi Medical College, Kurnool, Andhra Pradesh
Dr. S.S. Rama Kalyana Praveen
Assistant Professor, Department of General Medicine, Viswabharathi Medical College, Kurnool, Andhra Pradesh
Dr. K. Bala Siddartha
Assistant Professor, Department of General Medicine, Viswabharathi Medical College, Kurnool, Andhra Pradesh
Dr. Vedanth Vasudevan
Intern, Department of General Medicine, Viswabharathi Medical College, Kurnool, Andhra Pradesh
Dr. P. Vivek
Senior Resident, Department of General Medicine, Viswabharathi Medical College, Kurnool, Andhra Pradesh