Z Gastroenterol 2021; 59(08): e228-e229
DOI: 10.1055/s-0041-1733669
Allgemeine Hepatologie
Dienstag, 14. September 2021, 15:10-16:30 Uhr, After-Work-Stream: Kanal 2
Stoffwechsel Ernährung und gastroenterologische Endokrinologie

Thyroid hormone dysfunction is associated with decompensated liver cirrhosis and acute-on-chronic liver failure

MM Langer
1   University Hospital Essen, University Duisburg-Essen, Department of Gastroenterology and Hepatology, Essen, Deutschland
,
S Guckenbiehl
1   University Hospital Essen, University Duisburg-Essen, Department of Gastroenterology and Hepatology, Essen, Deutschland
,
A Bauschen
1   University Hospital Essen, University Duisburg-Essen, Department of Gastroenterology and Hepatology, Essen, Deutschland
,
D Zwanziger
2   University Hospital Essen, University Duisburg-Essen, Department of Endocrinology, Diabetes and Metabolism and Division of Laboratory Research, Essen, Deutschland
,
LC Moeller
2   University Hospital Essen, University Duisburg-Essen, Department of Endocrinology, Diabetes and Metabolism and Division of Laboratory Research, Essen, Deutschland
,
CM Lange
1   University Hospital Essen, University Duisburg-Essen, Department of Gastroenterology and Hepatology, Essen, Deutschland
,
SFB-CRC/TR 296 › Author Affiliations
 

Background and aims Thyroid hormones (TH) are important regulators of cellular energy homeostasis and immune-metabolism, and may thereby impact on the pathogenesis of acute-on-chronic liver failure (ACLF). In the present study, we aimed to determine associations between TH and clinical stages of liver cirrhosis (LC) including ACLF, as well as with TH targets in immune cells.

Method Patients with compensated (n=163) or decompensated (n=169) LC or ACLF (n=36) were recruited from a prospective cohort study. TSH, FT3 and FT4 levels were determined by using immunoassay with chemiluminescence. Associations between TH and clinical parameters were assessed by regression analysis. Statistical significance was determined by t test or One-way ANOVA/Kruskal-Wallis test as appropriate depending on Normality test. PBMCs were phenotyped by flow cytometry.

Results TSH levels in patients with decompensated LC (2.81±0.21 mU/l) were increased compared to patients with compensated LC (2.01±0.12 mU/l, p=0.03) and ACLF (2.18±0.34 mU/l, p=0.42). Conversely, FT3 concentrations were significantly lower already in patients with decompensated LC (3.80±0.06 pmol/l) compared to compensated LC (4.79±0.06 pmol/l, p< 0.0001), and even more decreased in those with ACLF (3.24±0.15 pmol/l, p< 0.0001 for comp. vs. ACLF; p=0.01 for decomp. vs. ACLF).

Interestingly, decreased FT3 concentrations were associated with infections in patients with decompensated LC (3.45±0.10 pmol/l with vs. 3.90±0.07 pmol/l without infection, p=0.0009), while FT3 concentrations were not different in ACLF with (3.23±0.24 pmol/l) or without infections (3.25±0.16 pmol/l, p=0.796). FT3 concentrations correlated inversely with CLIF-OF-, CLIF-C-AD/ACLF- and MELD-scores (p< 0.0001). No relevant changes of FT4 concentrations were observed. Associations of TH levels with T cell phenotypes will be presented.

Conclusion Decompensated cirrhosis complicated with infections and ACLF in general are associated with profound alterations in TH balance, specifically with decreased FT3. Functional consequences of these findings will be explored in the new SFB-CRC/TR 296.



Publication History

Article published online:
07 September 2021

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