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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

Correlation of serum thyroid parameters to the international normalized ratio (INR).INR served as surrogate marker for liver function. TSH (A), TT3 (B), and TT4 (C) were weakly, inversely correlated to INR.
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pone.0132189.g003: Correlation of serum thyroid parameters to the international normalized ratio (INR).INR served as surrogate marker for liver function. TSH (A), TT3 (B), and TT4 (C) were weakly, inversely correlated to INR.

Mentions: Univariate regression analyses were performed with outcome as dependent variable with all thyroid parameters. This resulted in a significant correlation between recovery and TSH (regression coefficient -0.789, p = 0.016, OR 0.454), recovery and TT4 (regression coefficient -0.013, p = 0.003, OR 0.987) and recovery and TT3 (regression coefficient -1.318, p = 0.004, OR 0.268). There was no significant correlation between recovery and fT4 or fT3. Multivariate logistic analysis, with the final model including TSH and TT4, showed a significant correlation between the parameters mentioned above and recovery. For TSH, the regression coefficient reached -0.652 (p = 0.066) and the odds ratio for recovery reached 0.521. The regression coefficient for TT4 was -0.014 (p = 0.002), with an odds ratio for recovering of 0.986. In addition TSH, TT3, and TT4 were inversely correlated to international normalized ratio (INR) as surrogate measure of liver function (Fig 3A–3C). TT3 and TT4 were inversely correlated to the prevalence of hepatic encephalopathy (TT3: Spearman r = -0.3993, p < 0.001; TT4: r = -0.3984, p < 0.001).


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)

Correlation of serum thyroid parameters to the international normalized ratio (INR).INR served as surrogate marker for liver function. TSH (A), TT3 (B), and TT4 (C) were weakly, inversely correlated to INR.
© Copyright Policy
Related In: Results  -  Collection

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

pone.0132189.g003: Correlation of serum thyroid parameters to the international normalized ratio (INR).INR served as surrogate marker for liver function. TSH (A), TT3 (B), and TT4 (C) were weakly, inversely correlated to INR.
Mentions: Univariate regression analyses were performed with outcome as dependent variable with all thyroid parameters. This resulted in a significant correlation between recovery and TSH (regression coefficient -0.789, p = 0.016, OR 0.454), recovery and TT4 (regression coefficient -0.013, p = 0.003, OR 0.987) and recovery and TT3 (regression coefficient -1.318, p = 0.004, OR 0.268). There was no significant correlation between recovery and fT4 or fT3. Multivariate logistic analysis, with the final model including TSH and TT4, showed a significant correlation between the parameters mentioned above and recovery. For TSH, the regression coefficient reached -0.652 (p = 0.066) and the odds ratio for recovery reached 0.521. The regression coefficient for TT4 was -0.014 (p = 0.002), with an odds ratio for recovering of 0.986. In addition TSH, TT3, and TT4 were inversely correlated to international normalized ratio (INR) as surrogate measure of liver function (Fig 3A–3C). TT3 and TT4 were inversely correlated to the prevalence of hepatic encephalopathy (TT3: Spearman r = -0.3993, p < 0.001; TT4: r = -0.3984, p < 0.001).

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