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.
journal_name
Clin Endocrinol (Oxf)journal_title
Clinical endocrinologyauthors
Lin TY,Shekar AO,Li N,Yeh MW,Saab S,Wilson M,Leung AMdoi
10.1111/cen.13312subject
Has Abstractpub_date
2017-05-01 00:00:00pages
755-759issue
5eissn
0300-0664issn
1365-2265journal_volume
86pub_type
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journal_title:Clinical endocrinology
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