Relationships between serum thyroid hormone levels with HBV-DNA and liver function indexes in patients with chronic hepatitis B in plateau Tibetan inhabited areas / 中国医师杂志

ABSTRACT

Objective:To detect serum thyroid hormone level, HBV-DNA expression level and liver function index in patients with chronic hepatitis B (CHB) in plateau Tibetan inhabited areas, and to analyze their correlations.Methods:From June 2016 to June 2018, 420 patients with HBsAg + CHB infection in our hospital were selected as the observation group, which was divided into Tibetan observation group ( n=300)and Han observation group ( n=120). According to the level of HBV-DNA, the observation group was divided into three groups A, B and C group. The healthy people in the same period were selected as the control group, 220 cases in Tibetan control group and 120 cases in Han control group. The expression level of HBV-DNA was detected by fluorescence quantitative polymerase chain reaction (qRT-PCR). Serum levels of thyroid stimulating hormone (TSH), triiodothyronine (T3), tetraiodothyronine (T4), free triiodothyronine (FT3), and free tetraiodothyronine (FT4) were measured by chemiluminescence. Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), and total bile acid (TBA) levels were measured by automatic biochemical analyzer and kit; the prothrombin time (PT) was measured by hemagglutination analyzer. Results:The levels of serum ALT, AST, HBV-DNA, TBA, PT, laminin (LN), procollagen-Ⅲ (PC-Ⅲ), collagen-Ⅳ (C-Ⅳ) and hyaluronidase (HAC) in Tibetan and Han observation group were significantly higher than those in Tibetan and Han control group ( P<0.05). The level of serum HAC in Tibetan patients with CHB was significantly higher than that in Han CHB patients ( P<0.05); the level of serum ALT, AST, PT, TBA, C-Ⅳ, PC-Ⅲ, HAC, LN increased with the level of serum HBV-DNA in patients with CHB ( P<0.05); the level of serum TSH, T3, T4, FT3, FT4 and T3/T4 ratio in Tibetan and Han patients with CHB had no significant difference ( P>0.05). With the increase of serum HBV-DNA level in Tibetan patients, serum T3 level and T3/T4 ratio in group B and C were significantly lower than those in the control group ( P<0.05), T4 level was significantly higher than that in the control group ( P<0.05), and the levels of FT3, FT4 and TSH were not significantly different from those in the control group ( P>0.05). The results of Pearson test showed that serum T3 level and T3/T4 ratio were negatively correlated with ALT, AST, PT, TBA, LN, HBV-DNA, C-Ⅳ and HAC levels in Tibetan CHB patients ( P<0.05); serum T4 level was positively correlated with ALT, AST, PT, TBA, LN, HBV-DNA, C-Ⅳ and HAC levels in Tibetan CHB patients ( P<0.05). Conclusions:Thyroid hormones TSH, T3, and T4 levels in CHB patients in plateau Tibetan inhabited areas are decreased significantly with the increase of HBV-DNA levels, and they are negatively correlated with ALT, AST, PT and TBA levels, suggesting that HBV infection may cause liver injury to some extent, and then affect the level of thyroid hormone.