A retrospective study:analyzing the risk factors of liver dysfunction in Graves’ disease / 中华内分泌代谢杂志

ABSTRACT

Objective Liver dysfunction is a common complication of hyperthyroidism [ mainly Graves’ disease(GD)], that may restrict the choice as well as affect the ultimate outcome of treatment. The purpose of this study was to describe the clinical and biochemical patterns in patients suffering from Graves’ disease and liver dysfunction and to determine influential factors. Methods A total of 1 928 patients received radioactive iodine, 131 I treatment. Before 131 I therapy, 24 h radioactive iodine uptake of thyroid(24 h RAIU), serum free triiodothyronine (FT3 ), free thyroxine( FT4 ), sensitive thyroid-stimulating hormone( sTSH), anti-thyrotrophin receptor antibody (TRAb), thyroglobulin antibody(TgAb), anti-thyroid peroxidase antibody(TPOAb), and serum hepatic function parameters etc were performed. Data were analyzed by the unpaired t-test, the independent samples t-test, the χ2 test, logistic regression, and Pearson bivariate correlation. Results Ages, the course of Graves’ disease, the weight of thyroid, FT4 , TPOAb, and TRAb in Graves’ disease patients complicated with liver dysfunction were higher than those in patients with normal hepatic function, as shown in table 1. The influential factors including age, course of Graves’ disease, heart rate, weight of thyroid, FT4, 24 h RAIU, TgAb, TPOAb, and TRAb. 24 h RAIU were the protecting factors. Age, course of Graves’ disease, heart rate, weight of thyroid, FT4 , TRAb, and TPOAb were the risk factors. Conclusion The risk of liver dysfunction in patients with Graves’ disease was increased in the following cases: age over 45 years, heart rate above 90 bpm, weight of thyroid more than 35 g, course of Graves’ disease longer than 3 years, FT4 greater than 70. 5 pmol/ L, TPOAb above 360 IU/ ml, and TRAb above 15 IU/ L. In these coses 131 I therapy will be recommended.