DOI: https://doi.org/10.22141/2224-0721.14.5.2018.142686

Parameters of thyroid homeostasis in patients with hepatitis of non-viral etiology

К.А. Сhympoi

Abstract


Background. The purpose of this study was to assess thyroid homeostasis in patients with chronic hepatitis of non-viral etiology and to analyze the correlation between serum thyroid parameters and A/C polymorphism of the deiodinase type 1 (DIO1) gene in these patients. Materials and methods. The study was conducted on 70 subjects: 50 patients with chronic hepatitis and 20 healthy controls. The thyroid homeostasis was evaluated using measurement of serum free thyroxine (fT4), free triiodothyronine (fT3) and thyroid stimulating hormone (TSH). The alleles of the polymorphic A/C sites in the DIO1 gene were stu­died. Results. The level of fT3 was reduced by 12.1 % (p < 0.01) in patients with chronic hepatitis, nonetheless being within the normal range in the majority of these patients with only 6 % showing fT3 level below the reference range. fT4 level was increased by 15.1 % (p < 0.01) in group of patients with chronic hepatitis comparing with healthy controls, although it was determined above the normal range only in 5 % of patients, whereas in 2 % of patient fT4 was even less than normal. These changes, obviously, are the result of a decrease in the activity of type 1 deiodinase and inhibition of T4 into T3 transformation. The theory might be confirmed by significantly reduced fT3/fT4 ratio (by 21.6 %; p < 0.001), that decreased below the reference range in 78 % patients with chro­nic hepatitis. At the same time, fT4/fT3 ratio increased by 24.1 % (р < 0.001) comparing with healthy controls, that can be attributed to the non-thyroidal illness syndrome in these patients. Elevation of TSH level by 28.7 % and TSH/fT3 ratio by 45.7 % was determined in patients with chronic hepatitis comparing with healthy controls (p < 0.05). The study did not reveal an association between the genotypes of DIO1 gene and the serum level of TSH. However, it has been established that the carriage of the C-allele DIO1 was associated with increasing fТ3 level and fТ3/fТ4 ratio, decreased fТ4/fТ3 ratio and fТ4 level, while the presence of А-allele was associated with decreased 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 with a reduction in free triiodothyronine level (by 12.1 %; p < 0.01), an increase in free thyroxine and thyroid stimulating hormone levels (by 15.1 %, p < 0.01 and 28.7 %, p < 0.05, respectively), a decrease in T3/T4 peripheral conversion rate (by 21.6 %; p < 0.001). Pathological changes in thyroid metabolism are associated with A/C polymorphism of the DIO1 gene.


Keywords


chronic hepatitis; polymorphism; gene; thyroid homeostasis

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