Development of the low-T3-syndrome and prognosis assessment in patients with liver cirrhosis.

C Rink, U Siersleben, J Haerting, T Mende, R Nilius
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Abstract

The aim of our study is to prove whether the development of the low-T3-syndrome in patients with liver cirrhosis is associated with their prognosis. For this purpose we determined the peripheral thyroid hormone levels in 28 patients with liver cirrhosis. For prognosis assessment we calculated the Prognostic Index (PI) on the basis of Cox's regression model as recently described by us. Calculating this index we used 11 parameters: liver morphology, consciousness, spider naevi, PCV, thrombocytes, gamma-GT, cholesterol, albumin, Quick's value, IgA, and potassium. It is demonstrated that there is an inverse correlation between T3-serum levels and PI (p = 0.03). An association could not be detected neither between reverse T3 and PI nor between T3 and rT3. On the other hand basal TSH was also inversely associated with PI. Thus, the low T3-serum levels did not induce a rise of basal TSH in cirrhotics. Moreover, the mean serum-T3-concentration differed significantly from that of 6 decreased patients and from that of the surviving (p = 0.00076). It seems to be true that low T3-serum levels are a very sensitive parameter for prognosis prediction in patients with liver cirrhosis.

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肝硬化患者低t3综合征的发展及预后评估。
我们的研究目的是为了证明肝硬化患者低t3综合征的发生是否与预后相关。为此,我们测定了28例肝硬化患者的外周甲状腺激素水平。对于预后评估,我们根据我们最近描述的Cox回归模型计算预后指数(PI)。计算该指数时,我们使用了11个参数:肝脏形态、意识、蜘蛛痣、PCV、血小板、γ - gt、胆固醇、白蛋白、Quick’s值、IgA和钾。结果表明,t3血清水平与PI呈负相关(p = 0.03)。在反向T3和PI之间以及T3和rT3之间均未检测到关联。另一方面,基础TSH也与PI呈负相关。因此,低t3血清水平不会导致肝硬化患者基础TSH升高。此外,血清t3平均浓度与6例下降患者和存活患者差异有统计学意义(p = 0.00076)。低t3血清水平似乎是预测肝硬化患者预后的一个非常敏感的参数。
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