NON-THYROIDAL ILLNESS SYNDROME IN PATIENTS WITH CHRONIC HEPATITIS OF NON-VIRAL ETHIOLOGY
INTRODUCTION: The effect of hormonal status on the functional state of the liver and endocrine disfunction caused by liver diseases are beyond doubt for most authors.
OBJECTIVES: The aim was to assess thyroid homeostasis in patients with chronic hepatitis and analyze the association between serum thyroid parameters and A/C polymorphism of the deiodinase type 1 (DIO1) gene.
METHODS: The study was conducted on 50 patients with chronic hepatitis and 20 healthy controls. The serum free thyroxine (fT4), free triiodothyronine (fT3) and thyroid stimulating hormone (TSH) were measured and fT3/fT4, fT4/fT3, TSH/fT3, TSH/fT4 ratio, thyroid index and total thyroid index were calculated. The alleles of the polymorphic A/C sites in the DIO1 gene were studied.
RESULT: The level of fT3 was reduced and fT4 level was increased in patients with chronic hepatitis. The fT3/fT4 ratio decreased below the reference range and fT4/fT3 ratio increased by 24,1%. Elevation of the TSH level and TSH/fT3 ratio were determined. The titres of tyroglobulin autoantibodies and antithyroid peroxidase antibodies significantly exceeded the control values.
It has been established that the carriage of the C-allele DIO1 was associated with an increasing fТ3 level and fТ3/fТ4 ratio, and a decreasing fТ4/fТ3 ratio and fТ4 level, while the presence of А-allele resulted in a decrease in the fТ3/fТ4 ratio and serum fТ3 with the increase in Т4 level in patients with chronic hepatitis.
CONCLUSIONS: Chronic hepatitis is accompanied by the development of non-thyroidal illness syndrome. Pathologycal changes in thyroid metabolism are associated with A/C polymorphism of the DIO1 gene.
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