ABSTRACT
To investigate day-night variations in thyroid stimulating hormone (TSH) and its relation with clinical status and metabolic parameters in patients with cirrhosis. Forty-one patients with negative thyroid antibodies and normal thyroid function tests who were diagnosed with cirrhosis were included. Thirty-five age- and gender-matched healthy subjects were included in control group.TSH, fT3, and fT4 levels, which were measured both in the morning and late evening. The difference between nocturnal TSH and morning TSH (ΔTSH) were compared between groups. Relation between Child-Turcotte-Pugh, model for End-Stage Liver Disease (MELD) and MELD-Na scores and levels of thyroid hormones, ΔTSH and serum sodium (Na) levels was investigated. Relation between ΔTSH and clinical status and metabolic parameters was also evaluated. The mean morning fT3, nocturnal fT3, nocturnal TSH, and ΔTSH levels were significantly lower, morning and nocturnal fT4 levels were higher in patients with cirrhosis (p<0.001, p<0.001, p=0.004, p<0.001, and p<0.001). As the ROC analysis, day-night variation was detected to be impaired in the event that difference between nocturnal TSH level and morning TSH level was lower than 1 uIU/mL in patients with cirrhosis with a sensitivity of 92.7% and specificity of 71.4% (p<0.001).A significant positive correlation was found between serum Na levels and fT3 in patients with cirrhosis (r=0.479, p=0.001), and a significant negative correlation was found between the severity of clinical status and low levels of fT3 in patients with cirrhosis (p<0.001).Nocturnal TSH increase does not occur in cases of cirrhosis without known thyroid disease and with normal thyroid function tests, which may be an early finding of impaired thyroid functions in patients with cirrhosis.
Subject(s)
Circadian Rhythm/physiology , Liver Cirrhosis/blood , Liver Cirrhosis/diagnosis , Thyrotropin/blood , Aged , Female , Humans , Liver Cirrhosis/physiopathology , Male , Middle Aged , Severity of Illness Index , Thyroid Function Tests , Thyroid Gland/physiopathology , Thyroxine/blood , Triiodothyronine/bloodSubject(s)
Gastrointestinal Stromal Tumors/diagnosis , Hemangioma, Cavernous/pathology , Jejunal Neoplasms/pathology , Diagnosis, Differential , Endoscopy, Gastrointestinal , Female , Gastrointestinal Hemorrhage/etiology , Hemangioma, Cavernous/complications , Humans , Jejunal Neoplasms/complications , Middle AgedSubject(s)
Capsule Endoscopy/methods , Gastrointestinal Hemorrhage/diagnosis , Pacemaker, Artificial , Aged , Arrhythmias, Cardiac/diagnosis , Arrhythmias, Cardiac/therapy , Atrioventricular Block/diagnosis , Atrioventricular Block/therapy , Capsule Endoscopy/adverse effects , Cardiac Pacing, Artificial/adverse effects , Cardiac Pacing, Artificial/methods , Female , Humans , Patient Safety , Risk AssessmentABSTRACT
BACKGROUND/AIMS: Ghrelin is a 28 amino acid peptide and the main source of serum ghrelin is the stomach. The aim of this study was to evaluate serum ghrelin levels in patients with hyperplastic gastric polyp. MATERIALS AND METHODS: Eighty patients (50 female, 30 male) were included in this study: 28 with hyperplastic gastric polyp, 20 with benign gastric ulcer and 32 with chronic active gastritis. Serum ghrelin levels were measured by radioimmunoassay method. RESULTS: Serum ghrelin level was significantly lower in patients with hyperplastic gastric polyp (1139.86 ± 279.23 pg/ml) than in those with benign gastric ulcer (1362.45 ± 335.35 pg/ml) and chronic active gastritis (1362.91 ± 269.67 pg/ml) (p=0.016 and p=0.003, respectively). The benign gastric ulcer and chronic active gastritis groups had similar serum values (p=0.996). Serum ghrelin level was not affected by Helicobacter pylori, with levels of 1298.70 ± 309.01 pg/ml and 1252.12 ± 303.04 pg/ml in 56 positive and 24 negative patients, respectively (p=0.536). In the patients with hyperplastic gastric polyp, Helicobacter pylori infection was found to have no effect on serum ghrelin level (p=0.855). CONCLUSIONS: Serum ghrelin levels of patients with hyperplastic gastric polyp were lower than in patients with benign gastric ulcer and chronic active gastritis. In patients with various benign stomach lesions, the presence of Helicobacter pylori does not seem to affect serum ghrelin levels.
