European Journal of Molecular & Clinical Medicine

To determine the incidence of non-alcoholic fatty liver disease in patients with thyroid dysfunction.
Materials & method: A cross-sectional study was conducted on 100 patients attending the out-patient and in-patient department of general medicine. Ethical committee clearance was obtained.A detailed history was taken with reference to the onset, duration, and progression of the symptoms, anorexia, malaise, fatigue, weight loss, constipation, reflux, nausea, hematemesis, vomiting, pain in abdomen, itching, melena, fullness of abdomen, alcohol intake and amount, long-term diseases like diabetes mellitus, hypertension,  iron storage disorders, celiac disease, TPN, history of jejuno-ileal bypass, abetalipoproteinemia, disorders of copper metabolism, personal history and habits, family history, drug history, and such other relevant history.CBC, thyroid profile, liver function test, kidney function test, RBS, PPBS, FBS, lipid profile, blood urea, creatinine, HbA1c, total protein, albumin, globulin, A:G ratio and ultrasonography.
Results: In our study, elevated ALT and AST was reported among 40% and 37% of study subjects respectively. The incidence of non-alcoholic fatty liver disease (NAFLD) among the subjects having thyroid dysfunction was 36%.Univariate and multivariate analysis revealed that thyroid dysfunction and age > 50 years were independent risk factor of NAFLD.
Conclusion: Overall, our study suggests that thyroid function is associated with NAFLD.This is an important finding because it opens a discussionif the adequacy of the TSH level to a lower reference couldprevent the emergence of NAFLD.

Background: Thyroid disorders are the most common endocrine abnormality in the
world secondary to diabetes mellitus. Thyroid hormones are essential for growth,
neuronal development, reproduction and regulation of energy metabolism. It influences
the metabolism of all substrates including minerals. Many studies have shown that
mineral metabolism is frequently disturbed in thyroid disorders.
Materials and Methods: The study was conducted on sixty newly confirmed
hypothyroid cases based on the thyroid profile and sixty euthyroid cases were recruited
as controls. Blood samples were collected from all the patients for the estimation of
serum T3, T4, FT3, FT4, TSH, calcium, phosphorus and magnesium by auto analyzer
method. Modified spectrophotometric micro-method was used to measure Serum
copper using Bathocuprine Disulphonate Disodium Salt (BCDS) and Guanidine
hydrochloride salt. The Statistical software namely SPSS 18.0, and R environment
ver.3.2.2 were used for the analysis of the data.
Results: It was found that the levels of serum sodium, potassium and calcium were
significantly decreased in cases than the controls. Serum magnesium and phosphorus
were significantly elevated in cases than controls.
Conclusion: Serum calcium, magnesium and phosphorous levels are significantly
altered in patients having hypothyroidism. Thyroid diseases have wide spread systemic
manifestations including their effects on bone and mineral metabolism. Also thyroid
hormone affects the glomerular filtration rate, renal blood flow, tubular reabsorption
and excretion of minerals which have direct effect on Calcium, Magnesium and
phosphorous level. Thus monitoring of these minerals in hypothyroid patient will be of
great benefit in improving clinical manifestation and can be treated appropriately.

Background: Cirrhotic patients are more liable to thyroid dysfunction especially
hypothyroidism and may have thyroiditis and hyperthyroidism. The aim of this
work is the evaluation of thyroid dysfunction in elderly patients with chronic liver
disease. Patients and methods: A cross-sectional study included 54 elderly patients
with clinical, biochemical, and ultrasound evidence of cirrhosis of liver which was
carried out in Internal Medicine Department, Faculty of Medicine, Zagazig
University Hospitals. All subjects included in this study were elderly over 65 years
and subjected to through clinical examination and full history taking with special
stress on age, sex, comorbidities, medications, symptoms of hepatic decompensation
and symptoms of hypothyroidism or hyperthyroidism. The technical part was done
at Biochemistry Department in Zagazig University. We assessed complete blood
count, serm bilirubin, serum albumin, serum ALT and AST, serum creatinine,
serum urea, PT, PTT, INR, TSH, free T3, T4 and lipid profile. Results: There was a
statistically significant positive correlation between serum TSH and weight, BMI,
Child score, total, direct bilirubin, INR, serum cholesterol, LDL cholesterol and
triglycerides. There is significant negative correlation between TSH and total
leucocytic count, platelet count, serum albumin. There was a significant negative
correlation between free T4 and both weight and BMI. There is significant positive
correlation between free T3 and total leucocytic count, and platelet count. There is
non-significant correlation between free T3 and neither weight, BMI, age,
hemoglobin, serum albumin, serum creatinine, ALT, AST, INR, LDL or HDL
cholesterol There was a significant negative correlation between child score and
TSH while there is significant positive correlation between child score and both Ft4
and FT3. There is significant relation between presence and degree of ascites and
all of free T4, free T3 and TSH. Conclusion: There is important relation between
Child pough class and all of free T4, free T3 and TSH. There is significant relation
between grade of hepatic encephalopathhy and all of free T4, free T3 and TSH.