Prevalence of subclinical hypothyroidism in patients of chronic liver disease

Richa Giri; Vinay P. Singh; Saurabh Agarwal; Vinay Kumar

doi:10.18203/2320-6012.ijrms20230876

Authors

Richa Giri Department of Medicine, GSVM Medical College, Kanpur, Uttar Pradesh, India
Vinay P. Singh Department of Medicine, GSVM Medical College, Kanpur, Uttar Pradesh, India
Saurabh Agarwal Department of Medicine, GSVM Medical College, Kanpur, Uttar Pradesh, India
Vinay Kumar Department of Medicine, GSVM Medical College, Kanpur, Uttar Pradesh, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20230876

Keywords:

Chronic Liver Disease, CLD, Thyroid function, TSH, FT3

Abstract

Background: Chronic liver disease (CLD) is a continuous process of inflammation, destruction, and regeneration of liver parenchyma, which leads to fibrosis and cirrhosis. Liver plays an essential physiological role in thyroid hormone activation and inactivation, transport, and metabolism, as well as the synthesis of thyroid binding globulin. A complex relationship exists between thyroid and liver in health and disease.

Methods: 103 patients of CLD were included in this study from December 2020 to September 2022. They were classified as per child Pugh scoring after clinical assessment and investigations. Thyroid function profile was measured for all the patients.

Results: Among 103 patients, 8 (7.76%) patients were having overt hypothyroidism and 28 (27.18%) patients had subclinical hypothyroidism, while 67 (65.04%) patients had normal thyroid profile levels. There was significant correlation between CTP class and hypothyroidism status of patient (p value <0.001) with 25 (56.81%) patients of CTP class C having subclinical hypothyroidism, while 3 (7.5%) patients of CTP class B had subclinical hypothyroidism and none patient of CTP class A had subclinical hypothyroidism.

Conclusions: Our study found that there was increased prevalence of subclinical hypothyroidism in CLD patients which increased with severity of CLD as assessed with CTP class.

Metrics

Metrics Loading ...

References

Sharma A, Nagalli S. Chronic Liver Disease. In: StatPearls. Treasure Island (FL): StatPearls Publishing. 2022.

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.

Pugh RN, Murray-Lyon IM, Dawson JL, Pietroni MC, Williams R. Transection of the oesophagus for bleeding oesophageal varices. Br J Surg. 1973;60(8):646-9.

Tsoris A, Marlar CA. Use Of The Child Pugh Score In Liver Disease. In: StatPearls. Treasure Island (FL): StatPearls Publishing. 2022.

Jameson JL, Mandel SJ, Weetman AP, Kasper DL, Hauser SL, Jameson JL, et al. Harrison's Principles of Internal Medicine Textbook. Disorders of the Thyroid gland 19th ed. New York McGraw-Hill Education. 2015;2283-308.

American Thyroid Association. Clinical Thyroidology for Patients. Available at: https://www.thyroid.org/patient-thyroid-information/ct-for-patients/vol-5-issue-6/. Accessed on 12 January 2023.

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.

Kayacetin E, Kisakol G, Kaya A. Low serum total thyroxine and free triiodothyronine in patients with hepatic encephalopathy due to non-alcoholic cirrhosis. Swiss Medical Weekly. 2003;133(1314).

Malik R, Hodgson H. The relationship between the thyroid gland and the liver. Int J Med. 2002;95(9):559-69.

Rodríguez-Torres M, Ríos-Bedoya CF, Ortiz-Lasanta G, Marxuach-Cuétara AM, Jiménez-Rivera J. Thyroid dysfunction (TD) among chronic hepatitis C patients with mild and severe hepatic fibrosis. Ann Hepatol. 2008;7(1):72-7.

Bandyopadhyay SK, Moulick A, Saha M, Dutta A, Bandyopadhyay R, Basu AK. A study on endocrine dysfunction in adult males with liver cirrhosis. J Indian Med Assoc. 2009;107(12):866.

Patira NK, Salgiya N, Agrawal D. Correlation of Thyroid Function Test with Severity of Liver Dysfunction in Cirrhosis of Liver. J Assoc Physicians India. 2019;67(3):51-4.

Punekar P, Sharma AK, Jain A. 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.

Feng HL, Li Q, Cao WK, Yang JM. Changes in thyroid function in patients with liver failure and their clinical significance: A clinical study of non-thyroidal illness syndrome in patients with liver failure. Hepatobiliary Pancreat Dis Int. 2020;19(6):561-6.