Department of Gastroenterology, The First People's Hospital of Chong Qing Liang Jiang New Area, Chongqing 401121, China.
Comput Intell Neurosci. 2022 Jun 6;2022:5365172. doi: 10.1155/2022/5365172. eCollection 2022.
The aims of this study were to expound the effect of thyroid hormone on the occurrence of liver cirrhosis and the severity classification of liver cirrhosis with meta-analysis.
A comprehensive search of PubMed, EMbase, The Cochrane Library, Web of Science, Google Scholar, CNKI, and WanFang Data databases and reference lists of retrieved articles was performed since the inception of each database until September 2021. Two reviewers independently screened literature, extracted data, and assessed the risk of bias by RevMan 5.3 software. In continuous variable analysis, the standardized mean difference (SMD) and 95% confidence interval (95% CI) were calculated through a random-effect model.
Eighteen case-control studies involving 3336 subjects were included for review. The results of the meta-analysis showed free triiodothyronine (FT3) and free thyroxine (FT4) levels in the liver cirrhosis group were lower than the control group (SMD = -1.29, 95% CI [-1.85, -0.74], < 0.001), (SMD = -0.61, 95% CI [-0.96, -0.26], < 0.001), thyroid-stimulating hormone (TSH) levels in liver cirrhosis group were higher than the control group (SMD = 0.34, 95%CI [0.06, 0.63], < 0.001) and that FT3 levels in Child-Pugh A VS B and Child-Pugh B VS C group were higher than the control group (SMD = 1.08, 95%CI [0.80, 1.37], = 0.008), (SMD = 0.68, 95%CI [0.38, 0.98], < 0.001).
Cirrhosis has decreased FT3 and FT4 levels and increased TSH levels. FT3 levels correlate negatively with the Child-Pugh score, and it is a measure of the severity of liver cirrhosis dysfunction. FT3 serum levels of thyroid hormones are a prognostic marker in liver cirrhosis.
本研究旨在通过荟萃分析阐述甲状腺激素对肝硬化发生和肝硬化严重程度分类的影响。
全面检索 PubMed、EMbase、The Cochrane Library、Web of Science、Google Scholar、CNKI 和万方数据库，检索时间为各数据库建库至 2021 年 9 月，由 2 名评价员独立筛选文献、提取资料并采用 RevMan 5.3 软件评价纳入研究的偏倚风险。连续性变量分析采用随机效应模型计算标准化均数差（SMD）及其 95%置信区间（95%CI）。
共纳入 18 项病例对照研究，涉及 3336 例患者。荟萃分析结果显示，肝硬化组游离三碘甲状腺原氨酸（FT3）和游离甲状腺素（FT4）水平低于对照组（SMD=-1.29，95%CI[-1.85，-0.74]，<0.001），（SMD=-0.61，95%CI[-0.96，-0.26]，<0.001），肝硬化组促甲状腺激素（TSH）水平高于对照组（SMD=0.34，95%CI[0.06，0.63]，<0.001），且 Child-Pugh A 级与 B 级、Child-Pugh B 级与 C 级间 FT3 水平均高于对照组（SMD=1.08，95%CI[0.80，1.37]，=0.008），（SMD=0.68，95%CI[0.38，0.98]，<0.001）。
肝硬化患者 FT3、FT4 水平降低，TSH 水平升高。FT3 水平与 Child-Pugh 评分呈负相关，是反映肝硬化肝功能障碍严重程度的指标。甲状腺激素 FT3 血清水平是肝硬化的预后标志物。
