title: Higher Thyroid-Stimulating Hormone, Triiodothyronine and Thyroxine Values Are Associated with Better Outcome in Acute Liver Failure.
abstract: BACKGROUND
  Changes in thyroid hormone levels, mostly as non-thyroidal illness syndrome (NTIS), have been described in many diseases. However, the relationship between acute liver failure (ALF) and thyroid hormone levels has not yet been clarified. The present study evaluates potential correlations of select thyroid functional parameters with ALF.
  
  
  METHODS
  84 consecutively recruited ALF patients were grouped according to the outcome of ALF (spontaneous recovery: SR; transplantation or death: NSR). TSH, free thyroxine (fT4), free triiodothyronine (fT3), T4, and T3 were determined.
  
  
  RESULTS
  More than 50% of patients with ALF presented with abnormal thyroid parameters. These patients had greater risk for an adverse outcome than euthyroid patients. SR patients had significantly higher TSH, T4, and T3 concentrations than NSR patients. Albumin concentrations were significantly higher in SR than in NSR. In vitro T3 treatment was not able to rescue primary human hepatocytes from acetaminophen induced changes in mRNA expression.
  
  
  CONCLUSIONS
  In patients with ALF, TSH and total thyroid hormone levels differed significantly between SR patients and NSR patients. This might be related to diminished liver-derived transport proteins, such as albumin, in more severe forms of ALF. Thyroid parameters may serve as additional indicators of ALF severity.
authors.affiliation: Department of Gastroenterology and Hepatology, University Hospital, University Duisburg, Essen, 45122, Essen, Germany.
authors.forename: Olympia
authors.initials: O
authors.lastname: Anastasiou
authors.affiliation: Department of Gastroenterology and Hepatology, University Hospital, University Duisburg, Essen, 45122, Essen, Germany.
authors.forename: Svenja
authors.initials: S
authors.lastname: Sydor
authors.affiliation: Department of Gastroenterology and Hepatology, University Hospital, University Duisburg, Essen, 45122, Essen, Germany.
authors.forename: Jan-Peter
authors.initials: JP
authors.lastname: Sowa
authors.affiliation: Department of Gastroenterology and Hepatology, University Hospital, University Duisburg, Essen, 45122, Essen, Germany; Regeneration and Repair Group, The Institute of Hepatology, London, WC1E 6HX, United Kingdom.
authors.forename: Paul
authors.initials: P
authors.lastname: Manka
authors.affiliation: Department of Gastroenterology and Hepatology, University Hospital, University Duisburg, Essen, 45122, Essen, Germany.
authors.forename: Antonios
authors.initials: A
authors.lastname: Katsounas
authors.affiliation: Regeneration and Repair Group, The Institute of Hepatology, London, WC1E 6HX, United Kingdom; Liver Unit, Barts Health NHS Trust, London, United Kingdom.
authors.forename: Wing-Kin
authors.initials: WK
authors.lastname: Syn
authors.affiliation: Department of Endocrinology and Metabolism, University Hospital, University Duisburg, Essen, 45122, Essen, Germany.
authors.forename: Dagmar
authors.initials: D
authors.lastname: Führer
authors.affiliation: Department of Gastroenterology and Hepatology, University Hospital, University Duisburg, Essen, 45122, Essen, Germany; Rodos BioTarget GmbH, Medical Park Hannover, 30625, Hannover, Germany.
authors.forename: Robert K
authors.initials: RK
authors.lastname: Gieseler
authors.affiliation: Department of Gastroenterology and Hepatology, University Hospital, University Duisburg, Essen, 45122, Essen, Germany.
authors.forename: Lars P
authors.initials: LP
authors.lastname: Bechmann
authors.affiliation: Department of Gastroenterology and Hepatology, University Hospital, University Duisburg, Essen, 45122, Essen, Germany.
authors.forename: Guido
authors.initials: G
authors.lastname: Gerken
authors.affiliation: Department of Endocrinology and Metabolism, University Hospital, University Duisburg, Essen, 45122, Essen, Germany.
authors.forename: Lars C
authors.initials: LC
authors.lastname: Moeller
authors.affiliation: Department of Gastroenterology and Hepatology, University Hospital, University Duisburg, Essen, 45122, Essen, Germany.
authors.forename: Ali
authors.initials: A
authors.lastname: Canbay
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D017114:Liver Failure, Acute / Q000097:blood* / Q000401:mortality / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D012189:Retrospective Studies; D013972:Thyrotropin / Q000097:blood*; D013974:Thyroxine / Q000097:blood*; D014284:Triiodothyronine / Q000097:blood*
chemical_list: D014284:Triiodothyronine; D013972:Thyrotropin; D013974:Thyroxine