Department of Pediatrics, Chungnam National University Hospital, Daejeon, 35015, South Korea.
J Pediatr Endocrinol Metab. 2020 Sep 25;33(9):1133-1137. doi: 10.1515/jpem-2020-0031.
Objectives Recently, several studies have reported the association between elevation of thyroid-stimulating hormone (TSH) levels and liver disease, especially, non-alcoholic fatty liver disease (NAFLD). We aimed to evaluate the incidence and risk factors of TSH elevation in patients with liver disease. Methods We retrospectively reviewed the data of patients aged <18 years who were diagnosed with liver disease between January 2015 and March 2019. Results Among the 77 patients, 17 (22.1%) had subclinical hypothyroidism and 3 (17.6%) progressed to overt hypothyroidism. A total of 26 (33.8%) patients had NAFLD, and 6 (23.1%) had subclinical hypothyroidism. The ultrasound grade of liver steatosis was not related to the elevation of TSH levels. The median age was significantly younger in patients with TSH elevation (5 vs. 9 years, p = 0.017). Albumin levels were significantly decreased (3.9 vs. 4.3 g/dL, p = 0.007), and total bilirubin levels were elevated (2.2 vs. 0.6 mg/dL, p = 0.001) in patients with subclinical hypothyroidism. Conclusions TSH elevation commonly occurs in patients with liver disease, especially those with younger age. The cause of liver disease was not a risk factor for TSH elevation.
目的 最近，有几项研究报告了促甲状腺激素（TSH）水平升高与肝脏疾病，尤其是非酒精性脂肪性肝病（NAFLD）之间的关联。我们旨在评估肝脏疾病患者 TSH 升高的发生率和危险因素。
方法 我们回顾性分析了 2015 年 1 月至 2019 年 3 月期间诊断为肝脏疾病的<18 岁患者的数据。
结果 在 77 名患者中，17 名（22.1%）患有亚临床甲状腺功能减退症，3 名（17.6%）进展为显性甲状腺功能减退症。共有 26 名（33.8%）患者患有 NAFLD，其中 6 名（23.1%）患有亚临床甲状腺功能减退症。肝脏脂肪变性的超声分级与 TSH 水平升高无关。TSH 升高患者的中位年龄明显较年轻（5 岁 vs. 9 岁，p=0.017）。亚临床甲状腺功能减退症患者的白蛋白水平显著降低（3.9 克/分升 vs. 4.3 克/分升，p=0.007），总胆红素水平升高（2.2 毫克/分升 vs. 0.6 毫克/分升，p=0.001）。
结论 TSH 升高在肝脏疾病患者中很常见，尤其是在年龄较小的患者中。肝脏疾病的病因不是 TSH 升高的危险因素。
