Low free T3 level may predict the severity of acute pancreatitis.

Postgraduate medicine Pub Date : 2024-06-01 Epub Date: 2024-06-24 DOI:10.1080/00325481.2024.2370238
Başak Can, Esra Deniz Kahvecioğlu
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Abstract

Objectives: To demonstrate that deterioration in thyroid function tests can serve as an indicator of severity and prognosis in acute pancreatitis despite a healthy thyroid gland.

Methods: This study is a retrospective, single-center study. Patients diagnosed with acute pancreatitis between May 2020 and June 2021 were evaluated. Acute pancreatitis was diagnosed and classified according to the 2012 revised Atlanta criteria. Patients were categorized into Non-Thyroidal Illness Syndrome and euthyroid groups and compared in terms of biochemical parameters and scoring systems such as Ranson, Glasgow, Balthazar and BISAP scores.

Results: A total of 152 patients were included in the study. Eighty-three patients (54%) were euthyroid, with free triiodothyronine (T3), free thyroxine (T4), and Thyroid-stimulating hormone (TSH) levels within normal limits. Sixty-nine patients (46%) had Non-Thyroidal Illness Syndrome with low serum free T3 levels and low/normal TSH levels. As expected, free T3 was significantly lower in the Non-Thyroidal Illness Syndrome group than in the euthyroid group (1.5 ± 0.04 vs 2.6 ± 0.04, respectively, p < 0.0001). In the Non-Thyroidal Illness Syndrome group, Ranson score (3.35 ± 0.2 vs 2.11 ± 0.18 p < 0.0001), Glasgow (2.4 ± 0.2 vs 1.3 ± 0.1, p < 0.0001), Atlanta (p = 0.007), and Balthazar (2.1 ± 0.1 vs 1.4 ± 0.1, p = 0.001) scores were significantly higher than euthyroid group.

Conclusion: Non-Thyroidal Illness Syndrome provides insight into the prognosis of acute pancreatitis. Free T3 values are a significant parameter that may indicate the prognosis of acute pancreatitis. We believe that free T3 could be incorporated into an ideal scoring system in a disease such as acute pancreatitis, where early determination of prognosis is known to significantly reduce mortality.

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低游离 T3 水平可预测急性胰腺炎的严重程度。
目的证明尽管甲状腺健康,但甲状腺功能检测的恶化可作为急性胰腺炎严重程度和预后的指标:本研究是一项回顾性单中心研究。对 2020 年 5 月至 2021 年 6 月期间诊断为急性胰腺炎的患者进行了评估。根据 2012 年修订的亚特兰大标准对急性胰腺炎进行诊断和分类。患者被分为非甲状腺疾病综合征组和甲状腺功能正常组,并在生化指标和评分系统(如兰森、格拉斯哥、巴尔塔扎尔和BISAP评分)方面进行比较:研究共纳入了 152 名患者。83名患者(54%)甲状腺功能正常,游离三碘甲状腺原氨酸(T3)、游离甲状腺素(T4)和促甲状腺激素(TSH)水平均在正常范围内。69名患者(46%)患有非甲状腺疾病综合症,血清游离 T3 水平低,促甲状腺激素水平低/正常。不出所料,非甲状腺疾病综合征组的游离 T3 明显低于甲状腺功能正常组(分别为 1.5 ± 0.04 vs 2.6 ± 0.04,p p p = 0.007),巴尔塔扎尔(2.1 ± 0.1 vs 1.4 ± 0.1,p = 0.001)评分明显高于甲状腺功能正常组:结论:非甲状腺疾病综合征有助于了解急性胰腺炎的预后。游离 T3 值是一个重要参数,可预示急性胰腺炎的预后。我们认为,游离 T3 可被纳入急性胰腺炎等疾病的理想评分系统,因为早期确定预后可显著降低死亡率。
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