Endocrine Abstracts

Introduction: In patients with Graves’ disease, uncontrolled thyrotoxicosis causes liver dysfunction in 37 to 78% of cases. This is commonly revealed by abnormal elevation of liver enzymes including hepatic cytolysis and cholestasis. The aim of the present study was to determine the prevalence of liver dysfunction and its associated factors in patients with Graves’ disease.

Methods: This was a monocentric retrospective study including 108 patients with hyperthyroidism secondary to Graves’ disease. Patients with previous history of liver diseases were excluded. Baseline clinical and biological data were collected.

Results: The mean age at the diagnosis of Graves’ disease was 45.9 ± 13.9 with a sex-ratio (F/M) of 1.9. Biochemical investigations revealed hepatic cytolysis and cholestasis in 20.6 and 33.3% of cases, respectively. The elevation of alkaline phosphatase was the most common abnormality (26.7 %). FT4 level (P<0.001), creatinine clearance (P=0.036) and transaminase levels (P<0.001) were significantly higher in patients with cholestasis compared with those without cholestasis. Moreover, male gender (Or=1.7, P=0.045), smoking (Or=4.0, P=0.002), and regular alcohol consumption (Or=5.6, P=0.027) were associated to cholestasis. Alcohol consumption (P=0.013) was also associated with an increased risk of cytolysis. Patients with hepatic cytolysis had higher levels of FT4 (P=0.044), alkaline phosphatase levels (P=0.019) and GGT levels (P<0.001) than those without cytolysis.

Conclusions: Graves’ disease is associated with a considerable risk of liver dysfunction. The present study showed that gender, smoking alcohol consumption and the severity of hyperthyroidism significantly interfere with liver dysfunction.