Online ISSN: 2515-8260

Keywords : free T4


A HOSPITAL BASED PROSPECTIVE STUDY TO CORRELATE THE SEVERITY OF CHRONIC RENAL FAILURE AND ALTERATIONS OF THYROID INDICES AT TERTIARY CARE CENTRE

Sawan Agrawal, Regia Sultana, Suvajit Chakraborty, Rahul Deb Chakrabarty, Babul Akhtar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 1666-1672

Background: The evaluation of thyroid function in systemic illness remains complex because the changes occur at all levels of the hypothalamic-pituitary-thyroid axis. So, it is prudent for the internist and treating physician to be aware of thyroid dysfunction so that early intervention can be instituted to improve the outcome. The aim of this study to correlate the severity of chronic renal failure and alteration of thyroid indices at tertiary care centre.
Materials& Methods: A hospital based prospective study done on 40 chronic renal failure patients admitted in medical ward at KPC Medical College, Jadavpur, Kolkata, West Bangal, India during one year period. Patients who fulfill the criteria for CRF and who are on conservative management were taken for the study. The correlation between the thyroid indices were analyzed and interpreted by the Karl Pearson’s coefficient(r). The interpretation of statistical procedures was performed by the statistical package SPSS (22.0 V). The value of P<0.05 was considered as significant.
Results: Among 40 patients, 10 patients were female, and 30patients were male. The mean age of the male and female patients was 52.76±11.65 and 50.45±7.32 years respectively. The prevalence of low T3 syndrome was 52.5% (21 cases) and the low T4 syndrome was 22.5 % (9 cases). The prevalence of TSH in hypothyroidism range was 5% (2cases). Among the males 46.66% of patients had low T3 syndrome. And among the females was 70%. The difference was not statistically significant P>0.05. The prevalence of low T4 among the males was 20% and among the females was 30%. The difference among the sexes was not statistically significant i.e. P>0.05. Theprevalence of TSH in clinical hypothyroidism range among males was 3.33% and among the females was 10%. The prevalence between the sexes was not statistically significant(P>0.05).
Conclusion: We concluded that serum level of total T3 and free T4 is directly proportional to creatinine clearance level. Alteration in the values of T3 and T4 occurs as a part of body adaptation mechanism to conserve energy.

To Study Serum HDL Level in Subclinical Hypothyroidism and Its Association with TSH: A Case Control Study

Nehal Patel,Nitish Thakur, Sahil Chhabra, Sevy Puri,Luqman Hafeez, Kiran Kumar Singal

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 218-222

Objectives:1)To study level of serum highdensity lipoprotein (HDL) level in subclinical
hypothyroidism andeuthyroid patients 2) To study association between serum HDL and
serum TSH in subclinical hypothyroidism.
Materials and Methods:The study was hospital based observational study which
included15 patients of subclinical hypothyroidism and 15 patient’s euthyroid after
diagnosis based on theirserum thyroid stimulating hormone (TSH), freeT3 and freeT4
level done during their regular visit to outpatient medicine department.Bloodsample
was collected of all the participants after an overnight (12hours) fasting and serum high
density lipoprotein levels was estimated. Statisticalanalysis was done on collected data.
Results: Participants with euthyroidism and subclinical hypothyroidism showed no
significant difference in serum high density lipoprotein levels and a negative correlation
was found between serum TSH and serum HDL level in subclinical hypothyroidism
group.
Conclusions:Thyroid hormones have various effects on lipid metabolism.The
effects of subclinical hypothyroidism on serum HDL level were not statistically
significantand a negative correlation between serum TSH and serum HDL which was
suggestive of linear decrease in serum HDL with increase in serum TSH levels.

LOW SERUM FREE TRI-IODOTHYRONINE HORMONE AS A POSSIBLE PROGNOSTIC FACTOR IN ALCOHOL RELATED LIVER DISEASE

Dr Leelaraghavan G R, Dr Gnanendra D M,Dr sheshanv.s,Dr Kiran S,Dr Abhiman Shetty B,Dr R Madhumathi

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 5004-5009

Introduction: The levels of thyroid hormone & thyroid binding proteins are altered in patients of
chronic liver disease. Our aim was to assess the serum freeT3 and serum free T4 levels, in alcohol
related liver disease and to find the correlation between thyroid hormone levels and severity of
alcohol related liver disease.
Methods: A cross sectional study, with a sample size of 50, was done to assess the serum free T3
andserum free T4 levels of thyroid function andto correlate them with prognostic factors of alcohol
related liver disease, i.e.MELD-Na - which is derived by adding serum sodium to the original Model
for End-Stage Liver Disease (MELD) score and Maddrey’sDiscriminant Function (DF).Statistical
analysis was done with - Chi-Square test, p value <0.001 was considered as statistically significant.
Results: Of the 50 patients, low serum free T3 levels were found in 29 patients, among them15
patients had DF<32; 14 patients had DF>32(p value <0.001), and 14 patients had MELD-Na<24.50;
15 patients had MELD-Na >24.50(p value <0.006). Low serum freeT4 levels were found in 12
patients, among them 4 patients had DF<32;8 patients had DF >32 (p value <0.001), and 8 patients
had MELD <24.50; 4 patients had MELD >24.50(p value <0.825).
Conclusion: Significant decrease in the serum free T3 levels was found in patients of alcohol related
liver disease with Maddrey’sDiscriminant Function >32 and MELD-Na >24.50 (both prognostic
markers of more severe liver disease). Hence, low serum free T3 level can be used as a prognostic
indicator of severity of alcohol related liver disease.