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Higher Thyroid-Stimulating Hormone, Triiodothyronine and Thyroxine Values Are Associated with Better Outcome in Acute Liver Failure.

Anastasiou O, Sydor S, Sowa JP, Manka P, Katsounas A, Syn WK, Führer D, Gieseler RK, Bechmann LP, Gerken G, Moeller LC, Canbay A - PLoS ONE (2015)

Bottom Line: These patients had greater risk for an adverse outcome than euthyroid patients.SR patients had significantly higher TSH, T4, and T3 concentrations than NSR patients.Albumin concentrations were significantly higher in SR than in NSR.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterology and Hepatology, University Hospital, University Duisburg, Essen, 45122, Essen, Germany.

ABSTRACT

Introduction: Changes in thyroid hormone levels, mostly as non-thyroidal illness syndrome (NTIS), have been described in many diseases. However, the relationship between acute liver failure (ALF) and thyroid hormone levels has not yet been clarified. The present study evaluates potential correlations of select thyroid functional parameters with ALF.

Methods: 84 consecutively recruited ALF patients were grouped according to the outcome of ALF (spontaneous recovery: SR; transplantation or death: NSR). TSH, free thyroxine (fT4), free triiodothyronine (fT3), T4, and T3 were determined.

Results: More than 50% of patients with ALF presented with abnormal thyroid parameters. These patients had greater risk for an adverse outcome than euthyroid patients. SR patients had significantly higher TSH, T4, and T3 concentrations than NSR patients. Albumin concentrations were significantly higher in SR than in NSR. In vitro T3 treatment was not able to rescue primary human hepatocytes from acetaminophen induced changes in mRNA expression.

Conclusions: In patients with ALF, TSH and total thyroid hormone levels differed significantly between SR patients and NSR patients. This might be related to diminished liver-derived transport proteins, such as albumin, in more severe forms of ALF. Thyroid parameters may serve as additional indicators of ALF severity.

No MeSH data available.


Related in: MedlinePlus

Distribution of thyroid function parameters in ALF.Individual parameters are plotted for the spontaneous remission (SR) and for the non-spontaneous remission (death or liver transplantation) patients with ALF. TSH (A), total T3 (TT3, C), and total T4 (TT4, E) were significantly lower in the NSR group. Free T3 (fT3, B) and free T4 (fT4, D) did not differ between the groups.
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pone.0132189.g001: Distribution of thyroid function parameters in ALF.Individual parameters are plotted for the spontaneous remission (SR) and for the non-spontaneous remission (death or liver transplantation) patients with ALF. TSH (A), total T3 (TT3, C), and total T4 (TT4, E) were significantly lower in the NSR group. Free T3 (fT3, B) and free T4 (fT4, D) did not differ between the groups.

Mentions: Individual serum concentrations of thyroid parameters were analyzed for differences between SR and NSR. TSH, TT4, and TT3 were significantly higher in the SR group (Fig 1A, 1C and 1E), while there was no significant difference in the free hormone concentrations fT4 and fT3 (Fig 1B and 1D). In addition, albumin was significantly lower in the NSR group than in SR patients (Fig 1F). Incidence of low albumin (< 3.4g/dl) was significantly higher in NSR patients (78.9%) than in the SR group (40.7%; p = 0.005). Prevalence of low TT3 or low TT3 and TT4 was significantly higher in the NSR group (Fig 2A and 2B). The degree of total thyroid hormone reduction appears to correlate with the prognosis of ALF.


Higher Thyroid-Stimulating Hormone, Triiodothyronine and Thyroxine Values Are Associated with Better Outcome in Acute Liver Failure.

Anastasiou O, Sydor S, Sowa JP, Manka P, Katsounas A, Syn WK, Führer D, Gieseler RK, Bechmann LP, Gerken G, Moeller LC, Canbay A - PLoS ONE (2015)

Distribution of thyroid function parameters in ALF.Individual parameters are plotted for the spontaneous remission (SR) and for the non-spontaneous remission (death or liver transplantation) patients with ALF. TSH (A), total T3 (TT3, C), and total T4 (TT4, E) were significantly lower in the NSR group. Free T3 (fT3, B) and free T4 (fT4, D) did not differ between the groups.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4493082&req=5

pone.0132189.g001: Distribution of thyroid function parameters in ALF.Individual parameters are plotted for the spontaneous remission (SR) and for the non-spontaneous remission (death or liver transplantation) patients with ALF. TSH (A), total T3 (TT3, C), and total T4 (TT4, E) were significantly lower in the NSR group. Free T3 (fT3, B) and free T4 (fT4, D) did not differ between the groups.
Mentions: Individual serum concentrations of thyroid parameters were analyzed for differences between SR and NSR. TSH, TT4, and TT3 were significantly higher in the SR group (Fig 1A, 1C and 1E), while there was no significant difference in the free hormone concentrations fT4 and fT3 (Fig 1B and 1D). In addition, albumin was significantly lower in the NSR group than in SR patients (Fig 1F). Incidence of low albumin (< 3.4g/dl) was significantly higher in NSR patients (78.9%) than in the SR group (40.7%; p = 0.005). Prevalence of low TT3 or low TT3 and TT4 was significantly higher in the NSR group (Fig 2A and 2B). The degree of total thyroid hormone reduction appears to correlate with the prognosis of ALF.

Bottom Line: These patients had greater risk for an adverse outcome than euthyroid patients.SR patients had significantly higher TSH, T4, and T3 concentrations than NSR patients.Albumin concentrations were significantly higher in SR than in NSR.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterology and Hepatology, University Hospital, University Duisburg, Essen, 45122, Essen, Germany.

ABSTRACT

Introduction: Changes in thyroid hormone levels, mostly as non-thyroidal illness syndrome (NTIS), have been described in many diseases. However, the relationship between acute liver failure (ALF) and thyroid hormone levels has not yet been clarified. The present study evaluates potential correlations of select thyroid functional parameters with ALF.

Methods: 84 consecutively recruited ALF patients were grouped according to the outcome of ALF (spontaneous recovery: SR; transplantation or death: NSR). TSH, free thyroxine (fT4), free triiodothyronine (fT3), T4, and T3 were determined.

Results: More than 50% of patients with ALF presented with abnormal thyroid parameters. These patients had greater risk for an adverse outcome than euthyroid patients. SR patients had significantly higher TSH, T4, and T3 concentrations than NSR patients. Albumin concentrations were significantly higher in SR than in NSR. In vitro T3 treatment was not able to rescue primary human hepatocytes from acetaminophen induced changes in mRNA expression.

Conclusions: In patients with ALF, TSH and total thyroid hormone levels differed significantly between SR patients and NSR patients. This might be related to diminished liver-derived transport proteins, such as albumin, in more severe forms of ALF. Thyroid parameters may serve as additional indicators of ALF severity.

No MeSH data available.


Related in: MedlinePlus