Schilddrüsenhormone bei Frauen mit Leberzirrhose

Summary Basal thyroid hormone levels were measured in 68 women with liver cirrhosis (LC) of different etiology (alcoholicn=34, posthepatitic Bn=9, PBCn=5, cryptogeneticn=18, M. Wilsonn=2). In addition the rise of TSH after 400 µg TRH was measured in 23 women with LC and compared with the data obtained from 17 women of a control group. There was no difference of the median T4-concentrations (LC 8.0 µg/dl versus 7.2 µg/dl) but a significant correlation of T4 to the grade of decompensation of LC. In contrast of T4 there was a marked decrease of T3 in LC-patients (109 ng/dl versus 143 ng/dl) and a rise of reverse T3 (0.21 ng/ml versus 0.13 ng/ml). The decrease of T3 and rise of reverse T3 equally correlated to the severeness of LC. TBG concentrations fell according to the grade of decompensation of LC and T4/TBG-quotient exhibited no difference to the control data (0.51 both). Though basal thyroid hormones and TSH show euthyroidism the significant augmented TSH release after TRH (-TSH 7.0 versus 3.2 µU/ml) indicate a status of latent hypothyroidism. In alcoholic cirrhosis the degree of TSH release was much higher than in non alcoholic cirrhosis. Estradiol and estrone levels correlated significantly negatively to T4, T3, estrone negatively to TBG and positively to reverse T3 but not to TSH and TSH release. Otherwise TSH release correlated positively to estradiol. The thyroid status in women with liver cirrhosis does not differ from the thyroid hormone profile found in men with cirrhosis.

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Abkürzungen K Kontrollen - LZ Leberzirrhose - n Anzahl - PBC primär biliäre Zirrhose - RT3 reverse T3 (35-Trijodthyronin) - T3 Trijodthyronin - T4 Thyroxin - TBG thyroxinbindendes Globulin - TRH Thyreotropin - TSH Thyreotropin-Releasing-Hormon