Tiffany Y Lin1, Anshula O Shekar2, Ning Li3, Michael W Yeh4, Sammy Saab5, Mark Wilson6, Angela M Leung7,8. 1. UCLA David Geffen School of Medicine, Los Angeles, CA, USA. 2. Department of Medicine, UCLA David Geffen School of Medicine, Los Angeles, CA, USA. 3. Department of Biomathematics, UCLA David Geffen School of Medicine, Los Angeles, CA, USA. 4. Section of Endocrine Surgery, Department of Surgery, UCLA David Geffen School of Medicine, Los Angeles, CA, USA. 5. Division of Gastroenterology, Department of Medicine, UCLA David Geffen School of Medicine, Los Angeles, CA, USA. 6. Sansum Clinic, Santa Barbara, CA, USA. 7. Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, UCLA David Geffen School of Medicine, Los Angeles, CA, USA. 8. Division of Endocrinology, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA.
Abstract
OBJECTIVE: Abnormal serum liver function tests are common in patients with untreated thyrotoxicosis, even prior to the initiation of antithyroidal medications that may worsen the severity of the abnormal serum liver biochemistries. There is a wide range of the incidence of these abnormalities in the published literature. The aim of this study was to assess the risks factors and threshold of thyrotoxicosis severity for developing an abnormal liver biochemical test upon the diagnosis of new thyrotoxicosis. DESIGN: Single-institution retrospective cohort study. PATIENTS: Patients of ≥18 years old receiving medical care at a large, academic, urban US medical centre between 2002-2016. MEASUREMENTS: Inclusion criteria were a serum thyroid stimulating hormone (TSH) concentration of <0·3 mIU/l or ICD-9 code for thyrotoxicosis, with thyrotoxicosis confirmed by either a concurrent elevated serum triiodothyronine (T3) or thyroxine (T4) concentration ([total or free] within 3 months), and an available liver biochemical test(s) within 6 months of thyrotoxicosis. The biochemical liver tests assessed were serum aspartate transaminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (AP), gamma-glutamyltransferase (GGT), total bilirubin, and conjugated bilirubin concentrations. RESULTS: In this cohort of 1514 subjects, the overall incidence of any biochemical liver test abnormality within 6 months of thyrotoxicosis was 39%. An initial serum TSH concentration <0·02 mIU/l, male gender, and African-American race were significant predictors of an abnormal serum liver biochemical test within 6 months of the diagnosis of new-onset untreated thyrotoxicosis. CONCLUSIONS: This study identifies risk factors for patients who develop an abnormal serum liver biochemical test result within 6 months of a diagnosis of untreated thyrotoxicosis.
OBJECTIVE: Abnormal serum liver function tests are common in patients with untreated thyrotoxicosis, even prior to the initiation of antithyroidal medications that may worsen the severity of the abnormal serum liver biochemistries. There is a wide range of the incidence of these abnormalities in the published literature. The aim of this study was to assess the risks factors and threshold of thyrotoxicosis severity for developing an abnormal liver biochemical test upon the diagnosis of new thyrotoxicosis. DESIGN: Single-institution retrospective cohort study. PATIENTS: Patients of ≥18 years old receiving medical care at a large, academic, urban US medical centre between 2002-2016. MEASUREMENTS: Inclusion criteria were a serum thyroid stimulating hormone (TSH) concentration of <0·3 mIU/l or ICD-9 code for thyrotoxicosis, with thyrotoxicosis confirmed by either a concurrent elevated serum triiodothyronine (T3) or thyroxine (T4) concentration ([total or free] within 3 months), and an available liver biochemical test(s) within 6 months of thyrotoxicosis. The biochemical liver tests assessed were serum aspartate transaminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (AP), gamma-glutamyltransferase (GGT), total bilirubin, and conjugated bilirubin concentrations. RESULTS: In this cohort of 1514 subjects, the overall incidence of any biochemical liver test abnormality within 6 months of thyrotoxicosis was 39%. An initial serum TSH concentration <0·02 mIU/l, male gender, and African-American race were significant predictors of an abnormal serum liver biochemical test within 6 months of the diagnosis of new-onset untreated thyrotoxicosis. CONCLUSIONS: This study identifies risk factors for patients who develop an abnormal serum liver biochemical test result within 6 months of a diagnosis of untreated thyrotoxicosis.
Authors: Rebecca S Bahn Chair; Henry B Burch; David S Cooper; Jeffrey R Garber; M Carol Greenlee; Irwin Klein; Peter Laurberg; I Ross McDougall; Victor M Montori; Scott A Rivkees; Douglas S Ross; Julie Ann Sosa; Marius N Stan Journal: Thyroid Date: 2011-04-21 Impact factor: 6.568
Authors: Albert Hsieh; Stephen Adelstein; Susan V McLennan; Paul F Williams; Elizabeth L Chua; Stephen M Twigg Journal: Endocrinol Diabetes Metab Date: 2019-07-15
Authors: Ismael da Silva; Rene da Costa Vieira; Carolina Stella; Edson Loturco; André Lopes Carvalho; Carlos Veo; Cristovam Neto; Sandra M Silva; Paulo D'Amora; Marcia Salzgeber; Delcio Matos; Celso R Silva; Jose R Oliveira; Iara Rabelo; Patricia Yamakawa; Rui Maciel; Rosa Biscolla; Maria Chiamolera; Renato Fraietta; Felipe Reis; Marcelo Mori; Dirce Marchioni; Antonio Carioca; Gustavo Maciel; Renato Tomioka; Edmund Baracat; Clovis Silva; Celso Granato; Ricardo Diaz; Bruno Scarpellini; Daniel Egle; Heidi Fiegl; Irmgard Himmel; Christina Troi; Robert Nagourney Journal: Oncotarget Date: 2018-08-03