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| Title | An Evaluation of Factors Which Affect Circulating Thyroid Hormone Levels in Liver Diseases |
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| Authors | Yasuhiko IWASAKI*, Hiroshi SATOH*, Hitoshi IKEDA*, Hidemasa UCHIMURA*, Akiyuki OHKUBO*, Shigenobu NAGATAKI* |
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| Organization | *Third Department of Internal Medicine, Faculty of Medicine, University of Tokyo |
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| Journal | The Japanese Journal of nuclear medicine |
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| Volume | 18 |
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| Number | 5 |
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| Page | 601-608 |
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| Year/Month | 1981/6 |
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| Article | Original article |
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| Publisher | THE JAPANESE SOCIETY OF NUCLEAR MEDICINE |
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| Abstract | [Abstract] Serum concentrations of thyroid hormones, thyroxine binding globulin (TBG) and TSH were measured in 12 patients with acute hepatitis, 18 with chronic active hepatitis (CAH) , 23 with chronic persistent hepatitis (CPH) , 28 with compensated liver cirrhosis, 14 with decompensated liver cirrhosis and 45 normal subjects. In CAH, serum concentrations of T4, T3 and reverse T3 (rT3) increased but values for T3-uptake decreased and free T4 and T3 indices did not differ from controls. Similar results were observed in CPH and compensated cirrhosis. These changes in circulating thyroid hormones were mainly due to the increase in serum TBG concentration which correlated significantly with serum GOT activities. In decompensated cirrhosis, serum T4 and T3 levels as well as free T4 and T3 indices decreased with concomitantly increased rT3 levels and hence, serum rT3/rT3 ratios showed a marked increase. However, serum TBG levels and values for T3-uptake did not differ from controls, indicating that changes in serum thyroid hormones were mainly due to the impaired peripheral conversion of T4. In compensated and decompensated cirrhosis altogether, serum TBG levels correlated positively with serum albumin levels and inversely with serum bilirubin levels and ICG retension rates, and rT3/T3 ratios correlated inversely with serum albumin levels and positively with ICG retension rates. In acute hepatitis, serum TBG, T4 and rT3 levels increased with normal T3 levels and serunm rT3/T3 ratios increased. It is suggested that abnormalities in circulating thyroid hormones in liver diseases are due to either changes in serum TBG concentrations, or impaired peripheral metabolism of thyroid hormones or both. |
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| Practice | Clinical medicine |
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| Keywords | Thyroid hormone, Thyroxine binding globulin, Acute hepatitis, Chronic hepatitis, Liver cirrhosis |
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| Japanese |
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| Title | 肝疾患における血中甲状腺ホルモン濃度の変動について |
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| Subtitle | 原著 |
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| Authors | 岩崎泰彦, 佐藤弘, 池田斉, 内村英正, 大久保昭行, 長滝重信 |
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| Organization | 東京大学第三内科 |
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| Journal | 核医学 |
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| Volume | 18 |
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| Number | 5 |
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| Page | 601-608 |
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| Year/Month | 1981/6 |
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| Article | 原著 |
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| Publisher | 日本核医学会 |
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| Abstract | 「要旨」各種肝疾患患者の血中甲状腺ホルモン, TBGおよびTSH濃度をRIA法にて測定した. 慢性活動性肝炎 (18例) ではT4, T3, rT3濃度とともにTBG濃度が有意に上昇, T3摂取率は減少しておりFT4I, FT3Iは健常者と差がなかった. 慢性非活動性肝炎 (23例) と代償性肝硬変 (28例) でも同様の変化を認めた. これらの変化は主にTBGの上昇によると考えられた. 非代償性肝硬変 (14例) ではT4, T3およびFT4I, FT3Iが有意に低下, rT3, rT3/T3比が有意に増加していた. しかしTBG, T3摂取率は健常者と差がなく, これらの変化は主にT4の末梢での代謝異常によるものと考えられた. なおTBG濃度は慢性肝炎ではSGOTと正の相関を, 肝硬変ではアルブミンと正の相関を, ICGおよびビリルビンと負の相関を認めた. 急性肝炎 (12例) ではTBG, T4, rT3およびrT3/T3比が有意に増加していた. 肝疾患の甲状腺ホルモン値異常にはTBG濃度とT4の末梢での代謝の変化を考慮すべきである. |
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| Practice | 臨床医学：一般 |
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| Keywords | Thyroid hormone, Thyroxine binding globulin, Acute hepatitis, Chronic hepatitis, Liver cirrhosis |
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