title: Assessment of thyroid and gonadal function in liver diseases.
abstract: BACKGROUND
  Liver is involved with the synthesis of carrier proteins and metabolism of various hormones and liver diseases may, therefore, be associated with various endocrine disturbances. This study was conducted to assess thyroid and gonadal function in subjects with acute hepatitis (AH), chronic liver disease (CLD), and those who had undergone liver transplantation (LT).
  
  
  METHODS
  Patients with AH, CLD with Child-Pugh stage A (CLD-1) and Child-Pugh stage B or C (CLD-2), and LT seen at our tertiary level hospital were assessed clinically, biochemically, and for thyroid and gonadal functions besides 25 healthy controls.
  
  
  RESULTS
  Thyroid dysfunction and hypogonadism were present in 14 (16%) and 24 (28%) patients with liver diseases respectively. Among thyroid dysfunction, the commonest was sick euthyroid syndrome six (7%), followed by subclinical hypothyroidism in three patients (3.5%), subclinical hyperthyroidism and thyrotoxicosis in two patients each (2.3%) and overt hypothyroidism in one patient. Among patients with LT and AH groups, the only abnormality was significantly lower total T3 compared with healthy controls. The CLD2 group had significantly lower levels of all thyroid hormones compared with controls and CLD1 group. Hypogonadism was commonest in patients with CLD-2 (14; 50%) followed by LT (3; 33%), CLD-1 (4; 20%), and AH (3; 14%). Hypogonadism was predicted by older age, lower levels of serum albumin, total cholesterol, and triglycerides and higher levels of plasma glucose, serum bilirubin, aspartate transaminases, and international normalized ratio. Gonadal functions showed recovery following LT.
  
  
  CONCLUSIONS
  Thyroid dysfunction and hypogonadism form an important part of the spectrum of acute and CLD, and patients with LT. Deterioration of synthetic functions of liver disease predicts presence of hypogonadism.
authors.affiliation: Department of Endocrinology, Army Hospital (R and R), Delhi Cantonment, New Delhi, India.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Kharb
authors.affiliation: Department of Endocrinology, Army Hospital (R and R), Delhi Cantonment, New Delhi, India.
authors.forename: M K
authors.initials: MK
authors.lastname: Garg
authors.affiliation: Department of Gastroenterology, Army Hospital (R and R), Delhi Cantonment, New Delhi, India.
authors.forename: Pankaj
authors.initials: P
authors.lastname: Puri
authors.affiliation: Department of Endocrinology, Army Hospital (R and R), Delhi Cantonment, New Delhi, India.
authors.forename: Karninder S
authors.initials: KS
authors.lastname: Brar
authors.affiliation: Department of Endocrinology, Army Hospital (R and R), Delhi Cantonment, New Delhi, India.
authors.forename: Aditi
authors.initials: A
authors.lastname: Pandit
authors.affiliation: Department of Gastroenterology, Army Hospital (R and R), Delhi Cantonment, New Delhi, India.
authors.forename: Sharad
authors.initials: S
authors.lastname: Srivastava
keywords: Acute hepatitis; acute liver disease; chronic liver disease; gonadal function; hypogonadism; hypothyroidism; liver transplantation; thyroid function