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Serum free thyroid hormone concentrations and indices in alcoholic liver cirrhosis, primary biliary cirrhosis and chronic active hepatitis



Serum free thyroid hormone concentrations and indices in alcoholic liver cirrhosis, primary biliary cirrhosis and chronic active hepatitis



Acta Endocrinologica. Supplementum 251: 21-26



Patients with alcoholic liver cirrhosis had a small increase in the mean serum free thyroxine (T4) concentrations, while the mean serum free T4 index and T4/TBG ratio (TBG = T4 -binding globulin) were significantly decreased. In primary biliary cirrhosis and chronic active hepatitis, the free T4 concentration, free T4 index and T4/TBG ratio were normal. In all 3 liver diseases studied, the mean serum free triiodothyronine (T3) concentration was normal and the mean free T3 index was reduced. The free hormone concentrations are therefore better indicators of clinical euthyroidism in chronic liver diseases than are the free hormone indices. In alcoholic liver cirrhosis very low serum T3 and high serum reverse concentrations were found, while in primary biliary cirrhosis and chronic active hepatitis the reciprocal changes in serum T3 and rT3 were small or absent. The observed increase in serum total T4 in primary biliary cirrhosis and chronic active hepatitis correlated to the observed increase in serum TBG. In the 2 liver diseases, an association between the elevated TBG and Estradiol (and estrone) levels could not be established, although it is known that increased estrogenic activity normally stimulates the hepatic synthesis of TBG. Serum bilirubin and plasma prothrombin time correlated with serum T3 and rT3, but there was an even better correlation between these liver function tests and the rT3/T3 ratio.

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Accession: 006401280

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PMID: 6404084


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