Title: Correlation of Thyroid Function Test with Severity of Liver Dysfunction in Cirrhosis of Liver
Authors: Dr Nilesh Kumar Patira, Dr Nirali Salgiya, Dr Deepak Agrawal
DOI: https://dx.doi.org/10.18535/jmscr/v5i5.109
Abstract
Aims and Objectives: To evaluate the Thyroid functions in patients with cirrhosis of liver and to assess the severity of liver dysfunction in relation with interpretation of thyroid functions.
Material and Methods: The present study was undertaken at Maharana Bhupal Govt. Hospital, attached to R.N.T. Medical College, Udaipur (Raj.).
1) This study included total 50 patients admitted at Maharana Bhupal Govt. Hospital, attached to R.N.T. Medical College Udaipur (Raj.) with clinical, biochemical, and radiological evidence of cirrhosis of liver.
2) All patients were subjected to medical examination as per the fixed Performa.
Inclusion criteria-
1) Patients with clinical, biochemical, and radiological evidence of cirrhosis of liver.
2) Patients who himself or his/her relatives gave consent.
Exclusion criteria-
1) Patients with diabetes.
2) Pregnant subjects.
3) Patient with prior h/o thyroid disease.
4) Patient receiving drugs that may interfere with thyroid hormone metabolism and function.
5) Patient with any other chronic illness (except liver cirrhosis).
Sample Analysis-
-Fasting morning blood sample was collected.
Observations and Conclusion: Prevalence of subclinical hypothyroidism with cirrhosis was 62%. 31 out of 50 patients had subclinical hypothyroidism. The study showed that prevalence of hypothyroidism in cirrhosis patients increases as the severity of cirrhosis increases and findings were statistically significant (p value 0.00).This study found association between serum T3 and severity of liver disease. As the severity of cirrhosis increases which is indicated by Child Pugh A to C, serum level of T3 reduces and findings were statistically significant (p value 0.00).All 50 patients of cirrhosis had their serum T4 level within normal limit and it does not change with severity of liver disease. This study found association between serum FT4 and severity of liver disease. As the severity of cirrhosis increases which is indicated by Child Pugh A to C, serum level of FT4 fall in low-normal or below normal value and findings were statistically significant (p value 0.00). This study found association between serum FT3 and severity of liver disease. As the severity of cirrhosis increases which is indicated by Child Pugh A to C, serum level of FT3 reduces. All patients of Child Pugh C had low FT3 level and the findings were statistically significant (p value 0.00). This study showed that serum bilirubin, prothombin time, INR, TSH level increases and serum albumin level, T3, FT3, and FT4 level reduces as the severity of cirrhosis increases.
According to this study all cirrhotic patients should undergo thyroid function evaluation as these patients are definitely associated with development of hypothyroidism. There is significant inverse correlation between serum level of T3, FT3, and FT4 with severity of cirrhosis. These parameters can be used as markers to indicate the severity of cirrhosis.
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