Raj Aswin, Pillai Gopalakrishna, Divakar Arun, Shivam Vishnu, Nair Anjaly
Internal Medicine, Amrita Institute of Medical Sciences and Research Centre, Kochi, IND.
Department of General Medicine, Coimbatore Medical College and Hospital, Coimbatore, IND.
Cureus. 2023 Mar 24;15(3):e36618. doi: 10.7759/cureus.36618. eCollection 2023 Mar.
Objective The main aim of this study is to understand the existing knowledge gap between thyroid function tests and the severity of liver cirrhosis as measured by the Child-Pugh score. Materials and methods This is a cross-sectional study conducted on 100 patients diagnosed with cirrhosis of liver. Serum triiodothyronine (free T3), thyroxine (free T4), and thyroid stimulating hormone (TSH) levels were measured, and the severity of liver cirrhosis was measured by Child-Pugh score and statistical analysis were done to investigate the association of free T3, free T4 and TSH levels with Child-A, Child-B, and Child-C severity groups. Results The results revealed that there is a statistically significant positive correlation between TSH levels and Child-Pugh score, whereas a statistically significant negative correlation was associated between free T3 (fT3), free T4 (fT4) levels, and Child-Pugh Score. Further, we also observed that the Child-C group has 7.5-fold risk of increased TSH levels (odds ratio {OR} = 7.553, 95% CI = 2.869-19.883, p = 0.000), has 5-fold risk of decreased fT3 levels (OR = 5.023, 95% CI = 1.369-18.431, p = 0.009) and has 6.4-fold risk of decreased fT4 levels (OR = 6.402, 95% CI = 2.516-16.290, p = 0.000). Conclusion Our results demonstrated that there is a positive and direct correlation associated between increasing TSH with severity of liver cirrhosis as measured by Child-Pugh score, whereas a negative and inverse correlation was observed between decreasing fT3 and fT4 levels with the severity of liver cirrhosis as measured by Child-Pugh score. This suggests that the Child-Pugh score can be used as a prognostic indicator in cirrhotic patients.
目的 本研究的主要目的是了解甲状腺功能检查与通过Child-Pugh评分衡量的肝硬化严重程度之间存在的知识差距。材料与方法 这是一项对100例被诊断为肝硬化的患者进行的横断面研究。测量血清三碘甲状腺原氨酸（游离T3）、甲状腺素（游离T4）和促甲状腺激素（TSH）水平，通过Child-Pugh评分评估肝硬化的严重程度，并进行统计分析以研究游离T3、游离T4和TSH水平与Child-A、Child-B和Child-C严重程度组之间的关联。结果 结果显示，TSH水平与Child-Pugh评分之间存在统计学上显著的正相关，而游离T3（fT3）、游离T4（fT4）水平与Child-Pugh评分之间存在统计学上显著的负相关。此外，我们还观察到，Child-C组TSH水平升高的风险增加7.5倍（优势比{OR}=7.553，95%置信区间=2.869-19.883，p=0.000），fT3水平降低的风险增加5倍（OR=5.023，95%置信区间=1.369-18.431，p=0.009），fT4水平降低的风险增加6.4倍（OR=6.402，95%置信区间=2.516-16.290，p=0.000）。结论 我们的结果表明，通过Child-Pugh评分衡量，TSH升高与肝硬化严重程度之间存在正相关且直接相关，而fT3和fT4水平降低与肝硬化严重程度之间存在负相关且反向相关。这表明Child-Pugh评分可作为肝硬化患者的预后指标。
