Correlation of Thyroid Function Tests in Patients with Liver Cirrhosis Due to Hepatitis C

Abstract

Objective: To determine correlation of thyroid function test in patients with liver cirrhosis due to hepatitis C. Methods: A cross-sectional study with non-probability purposive sampling technique was carried out at gastroenterology OPD Unit 1 LGH, Lahore from October 2019 to September 2020 after approval from ethical review board of PGMI/ LGH. Total 110 patients diagnosed with liver cirrhosis (Child Pugh Scores A, B, C) due to hepatitis C on abdominal ultrasound and 110 healthy individuals were included. After informed consent and physical examination, data was recorded and blood sample was taken for analysis of all liver enzymes (total bilirubin, aspartate aminotransferase, alanine aminotransferase and alkaline phosphatase, serum albumin) and thyroid function tests (free T3, free T4 and TSH). Pearson correlation and ANOVA test were applied to analyze data. Results: Out of 110 cirrhotic patients, 61.81% were males and 38.18% were females and mean age was 50.12+7.06. There were 58(52.72%) patients in Class C, 58(52.72%) patients in Class B according to Child Pugh Score. The level of free T3 was 2.43±1.78, free T4 was 12.19±3.20 and TSH was4.18±3.98 in cirrhotic patients. Significant correlation was found between aspartate aminotransferase, alanine aminotransferase and alkaline phosphatase with both FT3 and FT4. Correlation was also significant statistically between Free T3 (p <0.005) and Free T4 (p 0.045) with CPS. Conclusion: Patients with liver cirrhosis due to hepatitis C have significantly low free T3 and free T4 as compared to controls and significantly correlated with the liver disease severity. Hence, thyroid levels in cirrhotic patients may be used as a prognostic marker. Low FT3 and high TSH might be used as a predictor of mortality in liver cirrhosis.