Thyroid dysfunction in liver pathology

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Abstract

INTRODUCTION: A close functional relationship between the liver and thyroid gland suggests co-dependence of processes occurring in them not only under normal conditions, but also in pathology. The impact of thyroid dysfunction on change in the liver state has been extensively explored in the literature, while the converse — the impact of liver pathology on thyroid functional condition — requires additional analysis and study.

AIM: To study changes in the functional condition of the thyroid gland in the most common liver diseases.

An information search was conducted in the eLibrary, PubMed databases for the period from January 01, 2004 to April 01, 2004 with no restrictions on the type of publication. The following keywords were used: thyroid dysfunction, thyroxine, triiodothyronine, non-alcoholic fatty liver disease, chronic hepatitis, liver cirrhosis, hemochromatosis, Wilson's disease.

An analysis of the literature sources demonstrates various mechanisms of thyroid dysfunction in liver diseases. Non-alcoholic fatty liver disease (NAFLD) is indirectly related to impaired thyroid function and potentiation of metabolic syndrome manifestations through insulin resistance and obesity. Data on thyroid dysfunction in a patient with NAFLD due to the development of autoimmune damage and an increased risk of thyroid cancer also deserve the attention of the clinician. A probability for autoimmune thyroid damage should necessarily be taken into account in patients with autoimmune hepatitis. The incidence of interferon-induced thyroid dysfunction is currently declining due to changes in the antiviral therapy protocols. Literature data indicate an increased risk of thyroid cancer in infection with hepatitis C virus. Data on the impact of liver cirrhosis on thyroid function are contradictory, most commonly noted are reduction of triiodothyronine and thyroxine levels due to the involvement of liver in thyroid homeostasis (liver deiodinase system, thyroxine-binding globulin). Iron overload of thyrocytes in hemochromatosis can in some cases be accompanied by changes in thyroid status.

CONCLUSION: Thus, further investigation of thyroid status in liver diseases is needed, on the one hand, to elucidate mechanisms of thyroid dysfunction, and on the other, to determine a probable role of triiodothyronine and thyroxine levels as markers of severity of liver dysfunction. The data accumulated to date allow us to recommend studying thyroid hormonal status in chronic liver diseases.

About the authors

Oleg M. Uryasev

Ryazan State Medical University

Email: Uryasev08@yandex.ru
ORCID iD: 0000-0001-8693-4696
SPIN-code: 7903-4609

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Ryazan

Alexandra V. Solovieva

Ryazan State Medical University

Author for correspondence.
Email: savva2005@bk.ru
ORCID iD: 0000-0001-7896-6356
SPIN-code: 1943-7765

MD, Dr. Sci. (Medicine), Assistant Professor

Russian Federation, Ryazan

Svetlana V. Berstneva

Ryazan State Medical University

Email: berst.ru@mail.ru
ORCID iD: 0000-0002-3141-4199
SPIN-code: 6722-3203

MD, Dr. Sci. (Medicine), Assistant Professor

 
Russian Federation, Ryazan

Kirill O. Slabachkov

Ryazan State Medical University

Email: rooney121997@mail.ru
ORCID iD: 0000-0003-4638-9560
SPIN-code: 1238-6103
Russian Federation, Ryazan

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