P33. The prevalence of thyroid dysfunction in female patients with chronic hepatic disease

Liudmila Stavinskaia (MD), Uliana Tabuica (MD), Vlada-Tatiana Dumbrava (MD)

[Stavinskaia] State University of Medicine and Pharmacy ”Nicolae Testemitanu” Department of Obstetrics and Gynecology, [Tabuica] State University of Medicine and Pharmacy ”Nicolae Testemitanu”Department of Obstetrics and Gynecology, [ Dumbrava] State University of Medicine and Pharmacy ”Nicolae Testemitanu”

Interest in the effect of thyroid gland functioning on other organs has grown in recent years due to increased recognition that its disorders have a significant impact on health and quality of life. Thyroid hormones regulate the basal metabolism of cells, including hepatocytes, thereby affecting the functioning of the liver, which in turn metabolizes thyroid hormones,regulating their systemic effects. The objective of the study was to establish the prevalence of thyroid dysfunction in female patients with chronic liver disease and correlate this with the severity of the hepatic disease. Materials and methods: 80 patients were randomly selected from 319 according to the following criteria: • women of reproductive age with chronic liver disease (cirrhosis or hepatitis) of non-alcoholic origin, • absence of organic disease of the pelvic organs, • absence of alcoholic and autoimmune diseases of the liver and thyroid. Severity of hepatic disease was established on the basis of clinical symptoms, blood biochemistry, ultrasound and scintigraphy of liver and thyroid, and the level of thyroid hormones (total T3, T4, fT3, fT4, TSH). Patients were divided into two groups, depending on the type of liver disease. The control group contained 25 healthy women of reproductive age without hepatic or thyroid pathology. Results: The examined patient’s age varied between 18 and 40 years, mean age - 26.0±5 years. Among the 40 patients with cirrhosis, thyroid gland volume was increased by 19,0% avg. (±2,4%), reduced T3 and fT3, and increased rT3, compared to the control group (changes similar to those of euthyroid syndrome disease), that, probably, can be explained by transformation of T4 in T3. The T3/rT3 ratio was negatively correlated with the severity of cirrhosis. Among the 40 patients with chronic hepatitis, levels of T4, T3 and thyroxine-binding globulin were elevated by 63,4% avg. (±1,6%) but levels of TSH and fT4 were in normal range, so they were euthyroid. Conclusion. Most patients with chronic hepatic pathology are clinically euthyroid and this can be confirmed by normal level of TTH and fT4.