Abstract
Thyroid hormones regulate the renal hemodynamics and basal metabolic rate of most cells. This hospital-based case-control study was done to evaluate the changes in biochemical markers of liver and kidney function in hypothyroid subjects before and after treatment. The study included 176 subjects randomly selected from Thyroid clinics. Serum T3, T4, TSH, Liver and Kidney Function tests were analysed using standard kits. Forty-six hypothyroid patients were re-evaluated 6 weeks after thyroxine substitution therapy. Hypothyroid subjects (n=80) showed significantly raised serum creatinine and uric acid levels as compared to euthyroid subjects (n=96). After 6 weeks of thyroxine replacement, serum creatinine and uric acid decreased significantly and were comparable to euthyroid group. A positive correlation of ALT, AST, uric acid, protein and albumin with TSH levels (p<0.05) and negative correlation of serum T4 levels with ALT, AST, proteins (p<0.05) was observed in the hypothyroid group. Hypothyroidism results in reversible impairment of hepatorenal function.
Key Words: Hypothyroidism, Bilirubin, Liver enzymes, Creatinine, Uric Acid
Full Text
The Full Text of this article is available as a PDF (71.7 KB).
References
- 1.Boelaert K., Franklyn J.A. Thyroid hormone in health and disease. J Endocrinol. 2005;187:1–15. doi: 10.1677/joe.1.06131. [DOI] [PubMed] [Google Scholar]
- 2.Yen P.M. Physiology and molecular basis of thyroid hormone action. Physiol Rev. 2001;81:1097–142. doi: 10.1152/physrev.2001.81.3.1097. [DOI] [PubMed] [Google Scholar]
- 3.Shupnik M.A., Ridgway E.C., Chin W.W. Molecular biology of thyrotropin. Endocr Rev. 1989;10:459–75. doi: 10.1210/edrv-10-4-459. [DOI] [PubMed] [Google Scholar]
- 4.Malik R., Hodgson H. The relationship between the thyroid gland and the liver. Q J Med. 2002;95:559–569. doi: 10.1093/qjmed/95.9.559. [DOI] [PubMed] [Google Scholar]
- 5.Youssef W.I., Mullen K.D. The liver in other (nondiabetic) endocrine disorders. Clinics in Liver Disease. 2002;6(4):879–889. doi: 10.1016/S1089-3261(02)00049-1. [DOI] [PubMed] [Google Scholar]
- 6.Davis R.G., Madsen K.M., Fregly M.J., Tisher C.C. Kidney structure in hypothyroidism. Am J Pathol. 1983;113(1):41–49. [PMC free article] [PubMed] [Google Scholar]
- 7.Zimmerman R.S., Ryan J., Edwards B.S., Klee G., Zimmerman D., Scott N., Burnett J.C., Jr Cardio renal endocrine dynamics during volume expansion in hypothyroid dogs. Am J Physiol Regul Integr Comp Physiol. 1988;255:R61–R66. doi: 10.1152/ajpregu.1988.255.1.R61. [DOI] [PubMed] [Google Scholar]
- 8.Sterling L. Diagnosis and treatment of thyroid disease. Cleveland CRC Press, 1975: 9–51.
- 9.Caldwell G., Kellett H.A., Gow S.M., Beckett G.J., Sweeting V.M., Seth J., Toft A.D. A new strategy for thyroid function testing. Lancet. 1985;1:1117–1119. doi: 10.1016/S0140-6736(85)92429-8. [DOI] [PubMed] [Google Scholar]
- 10.Camacho G.D., Ceballos L.T., Angelin B.P., Moreno J.A.R., Nieto M.L.H., Gonzalez J.R. Renal failure and acquired hypothyroidism. Pedia Nephrol. 2003;18(3):290–292. doi: 10.1007/s00467-002-1033-9. [DOI] [PubMed] [Google Scholar]
- 11.Hollander J.G., Wulkan R.W., Mantel M.J., Berghout A. Correlation between severity of thyroid dysfunction and renal function. Clin Endocrinol. 2005;62(4):423–427. doi: 10.1111/j.1365-2265.2005.02236.x. [DOI] [PubMed] [Google Scholar]
- 12.Welsem M.E., Lobatto S. Treatment of severe hypothyroidism in a patient with progressive renal failure leads to significant improvement of renal function. Clin Nephrol. 2007;67(6):391–393. doi: 10.5414/cnp67391. [DOI] [PubMed] [Google Scholar]
- 13.Giordano N., Santacroce C., Mattii G., Geraci S., Amendola A., Gennari C. Hyperuricemia and gout in thyroid endocrine disorders. Clin Exp Rheumatol. 2001;19(6):661–665. [PubMed] [Google Scholar]
- 14.Capasso G., Santo N.G.D., Kinne R. Thyroid hormones and renal transport: Cellular and biochemical aspects. Kidney International. 1987;32:443–451. doi: 10.1038/ki.1987.231. [DOI] [PubMed] [Google Scholar]
- 15.Montenegro J., Gonzalez O., Saracho R., Aquirre R., Gonzalez O., Martinez I. Changes in renal function in primary hypothyroidism. Am J Kidney Dis. 1996;27(2):195–198. doi: 10.1016/S0272-6386(96)90539-9. [DOI] [PubMed] [Google Scholar]
- 16.Lippi G, Montagnana M, Targher G, Salvagno GL, Guidi GC. Relationship between thyroid status and renal function in a general population of unselected outpatients. Clin. Biochem 2008 Feb 5[Epub ahead of print]. PMID: 18280252. [DOI] [PubMed]
- 17.Huang M.J., Liaw Y.F. Clinical associations between thyroid and liver diseases. J Gastroenterol Hepatol. 1995;10:344–350. doi: 10.1111/j.1440-1746.1995.tb01106.x. [DOI] [PubMed] [Google Scholar]
- 18.Gaitan E., Cooper D.S. Primary hypothyroidism. Curr Ther Endocrinol Metab. 1997;6:94–98. [PubMed] [Google Scholar]
- 19.Targher G, Montagnana M, Salvagno G, Moghetti P, Zoppini G, Muggeo M, Lippi G. Association between serum TSH, free T4 and serum liver enzyme activities in a large cohort of unselected outpatients. Clin Endocrinol (OnlineEarly Articles). doi:10.1111/j.1365-2265.2007.03068.x. [DOI] [PubMed]
- 20.Kvetny J., Heldgaard P.E., Bladbjerg E.M., Gram J. Subclinical hypothyroidism is associated with a low-grade inflammation; increased triglyceride levels and predicts cardiovascular disease in males below 50 years. Clin Endocrinol (Oxf.) 2004;61(2):232–238. doi: 10.1111/j.1365-2265.2004.02088.x. [DOI] [PubMed] [Google Scholar]