Interrelationship between thyroid hormones and liver function biomarkers in patients with liver disease: A case-control study
Abstract
This study aimed to investigate the relationship between thyroid gland function and susceptibility to liver disease in an Iraqi patient population. The researchers worked in Iraq and survey ed consenting patients of diffe r ent ages who attended the Al-Hussein Teaching Hospital and the Ibn Al-Bitar Laboratory in Thi-Qar province. Further, there were fifty healthy controls, both male and female and of different ages who were sampled. In order to examine the association between thyroid hormones and liver functioning, blood serum was measured in terms of TSH, T 3 , T 4 , AST, ALT, and bilirubin in patients as well as controls. The results showed that patients who suffered liver disease had a lower body mass index (BMI) than the control group and that there were also no statistically significant differences in age. AST levels had a positive relationship with T 4 (r = 0.260) and a neg a tive relationship with TSH (r = – 0.131). Also, age had a positive correlation with the BMI (r = 0.381) and neg a tively correlated with bilirubin levels (r = – 0.274). The l iver is the important part of the metabolism of thyroid hormones and, vice versa, the level of thyroid hormones is necessary to ensure the proper functioning of liver and bilirubin metabolism. In addition to the established correlation of thyroid dysfunction with autoimmune diseases of the liver such as primary biliary cirrhosis and hypothyroidism that affect the liver, thyroid diseases can also be a cause of liver injury or affect liver function tests.References
Albuquerque-Souza, E., & Sahingur, S. E. (2022). Periodontitis, chronic liver diseases, and the emerging oral-gut-liver axis. Periodontology 2000, 89(1), 125–141.
Assy, N., Nasser, G., Djibre, A., Beniashvili, Z., Elias, S., & Zidan, J. (2009). Characteristics of common solid liver lesions and recommendations for diagnostic workup. World Journal of Gastroenterology, 15(26), 3217–3227.
Carulli, L., Ballestri, S., Lonardo, A., Lami, F., Violi, E., Losi, L., Bonilauri, L., Verrone, A. M., Odoardi, M. R., Scaglioni, F., Bertolotti, M., & Loria, P. (2013). Is nonalcoholic steatohepatitis associated with a high-though-normal thyroid stimulating hormone level and lower cholesterol levels? Internal and Emergency Medicine, 8(4), 297–305.
Center, S. A. (2007). Interpretation of liver enzymes. Veterinary Clinics of North America: Small Animal Practice, 37(2), 297–333.
Chen, S., Jin, Y., Xu, M., Zhang, P., Zhou, Y., Qian, X., Song, Q., Bu, S., Sun, J., & Li, L. (2022). Relationship between thyroid hormone and liver steatosis analysis parameter in obese participants: A case-control study. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 15, 887–896.
Chung, G. E., Kim, D., Kim, W., Yim, J. Y., Park, M. J., Kim, Y. J., Yoon, J. H., & Lee, H. S. (2012). Non-alcoholic fatty liver disease across the spectrum of hypothyroidism. Journal of Hepatology, 57(1), 150–156.
Hassan, M. M., Kaseb, A., Li, D., Patt, Y. Z., Vauthey, J. N., Thomas, M. B., Curley, S. A., Spitz, M. R., Sherman, S. I., Abdalla, E. K., Davila, M., Lozano, R. D., Hassan, D. M., Chan, W., Brown, T. D., & Abbruzzese, J. L. (2009). Association between hypothyroidism and hepatocellular carcinoma: A case-control study in the United States. Hepatology, 49(5), 1563–1570.
Larson, A. M., Polson, J., Fontana, R. J., Davern, T. J., Lalani, E., Hynan, L. S., Reisch, J. S., Schiødt, F. V., Ostapowicz, G., Shakil, A. O., & Lee, W. M. (2005). Acetaminophen-induced acute liver failure. Hepatology, 42(6), 1364–1372.
Lateef, D. A., Nasser, N. A., & Mohsein, O. A. (2024). The relationships between apelin, vaspin and thyroid hormone levels in obese diabetic and non-diabetic women. Journal of Experimental and Clinical Medicine, 41(2), 239–245.
Le Couteur, D. G., Blyth, F. M., Creasey, H. M., Handelsman, D. J., Naganathan, V., Sambrook, P. N., Seibel, M. J., Waite, L. M., & Cumming, R. G. (2010). The association of alanine transaminase with aging, frailty, and mortality. The Journals of Gerontology, Series A, Biological Sciences and Medical Sciences, 65(7), 712–717.
Lee, S. Y., & Pearce, E. N. (2023). Hyperthyroidism: A review. Journal of the American Medical Association, 330(15), 1472–1483.
Li, X., Feng, C., Hong, H., Zhang, Y., Luo, Z., Wang, Q., Luo, Y., & Tan, Y. (2022). Novel ACE inhibitory peptides derived from whey protein hydrolysates: Identification and molecular docking analysis. Food Bioscience, 48, 101737.
Maenhaut, C., Christophe, D., Vassart, G., Dumont, J., Roger, P. P., & Opitz, R. (2015). Ontogeny, anatomy, metabolism and physiology of the thyroid. In Feingold, K. R., Adler, R. A., Ahmed, S. F. et al. (Eds.). Endotext. MDText.com, Inc., South Dartmouth.
Martínez-Escudé, A., Pera, G., Costa-Garrido, A., Rodríguez, L., Arteaga, I., Expósito-Martínez, C., Torán-Monserrat, P., & Caballería, L. (2021). TSH levels as an independent risk factor for NAFLD and liver fibrosis in the general population. Journal of Clinical Medicine, 10(13), 2907.
Murali Krishna, S., Hegde, S. V., Chellathurai, M., Mohandas, N. J. A., Guruswamy, S., Pandit, S., Afra, A., Shetty, S., & Siripuram, C. (2024). Correlation between thyroid-stimulating hormone (TSH) and liver function test values in North Karnataka patients admitted to a tertiary care hospital. Cureus, 16(4), e59004.
Oh, C. M., Won, Y. J., Cho, H., Lee, J. K., Park, B. Y., Jun, J. K., Koh, D. H., Ki, M., Jung, K. W., & Oh, I. H. (2016). Alanine aminotransferase and gamma-glutamyl transferase have different dose-response relationships with risk of mortality by age. Liver International, 36(1), 126–135.
Opoku-Akyeampong, N. A. A. S., Agyei-Nkansah, A., & Yorke, E. (2021). Liver dysfunction associated with hyperthyroidism: Lessons from 2 Case reports. Clinical Case Reports, 9(6), e04067.
Piantanida, E., Ippolito, S., Gallo, D., Masiello, E., Premoli, P., Cusini, C., Rosetti, S., Sabatino, J., Segato, S., Trimarchi, F., Bartalena, L., & Tanda, M. L. (2020). The interplay between thyroid and liver: implications for clinical practice. Journal of endocrinological investigation, 43(7), 885–899.
Polyzos, S. A., Kang, E. S., Tsochatzis, E. A., Kechagias, S., Ekstedt, M., Xanthakos, S., Lonardo, A., Mantovani, A., Tilg, H., Côté, I., Grefhorst, A., Greene, M. W., Araujo-Vilar, D., Alisi, A., Casanueva, F., & Mantzoros, C. S. (2020). Commentary: Nonalcoholic or metabolic dysfunction-associated fatty liver disease? The epidemic of the 21st century in search of the most appropriate name. Metabolism, 113, 154413.
Punekar, P., Sharma, A. K., & Jain, A. (2018). A study of thyroid dysfunction in cirrhosis of liver and correlation with severity of liver disease. Indian Journal of Endocrinology and Metabolism, 22(5), 645–650.
Rodondi, N., den Elzen, W. P., Bauer, D. C., Cappola, A. R., Razvi, S., Walsh, J. P., Asvold, B. O., Iervasi, G., Imaizumi, M., Collet, T. H., Bremner, A., Maisonneuve, P., Sgarbi, J. A., Khaw, K. T., Vanderpump, M. P., Newman, A. B., Cornuz, J., Franklyn, J. A., Westendorp, R. G., Vittinghoff, E., … Thyroid Studies Collaboration (2010). Subclinical hypothyroidism and the risk of coronary heart disease and mortality. Journal of the American Medical Association, 304(12), 1365–1374.
Rousset, B., Dupuy, C., Miot, F., & Dumont, J. (2015). Chapter 2. Thyroid hormone synthesis and secretion. In: Feingold, K. R., Adler, R. A., Ahmed, S. F. et al. (Eds.). Endotext. MDText.com, Inc., South Dartmouth.
Rutherford, A., & Chung, R. T. (2008). Acute liver failure: Mechanisms of hepatocyte injury and regeneration. Seminars in Liver Disease, 28(2), 167–174.
Silveira, M. G., Mendes, F. D., Diehl, N. N., Enders, F. T., & Lindor, K. D. (2009). Thyroid dysfunction in primary biliary cirrhosis, primary sclerosing cholangitis and non-alcoholic fatty liver disease. Liver International, 29(7), 1094–1100.
Silveira, M. G., Mendes, F. D., Diehl, N. N., Enders, F. T., & Lindor, K. D. (2009). Thyroid dysfunction in primary biliary cirrhosis, primary sclerosing cholangitis and non-alcoholic fatty liver disease. Liver International, 29(7), 1094–1100.
Silveira, M. G., Mendes, F. D., Diehl, N. N., Enders, F. T., & Lindor, K. D. (2009). Thyroid dysfunction in primary biliary cirrhosis, primary sclerosing cholangitis and non-alcoholic fatty liver disease. Liver International, 29(7), 1094–1100.
Younossi, Z. M., Wong, G., Anstee, Q. M., & Henry, L. (2023). The global burden of liver disease. Clinical Gastroenterology and Hepatology, 21(8), 1978–1991.
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons «Attribution» 4.0 License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
