Clinical study of hepatic dysfunction and its correlative factors in newly diagnosed patients with Graves hyperthyroidism

Objective To investigate the incidence,clinical features and the possible risk factors of hepatic dysfunction in the newly diagnosed patients with Graves hyperthyroidism.Methods A retrospective analysis about total 204 newly diagnosed patients with Graves hyperthyroidism was studied.All the patients were divided into two groups by liver function:the hepatic dysfunction group (146 cases)and the normal group (58 cases).The gender composition,age,thyroid weight,24 h-131I intake rate,free triiodothyronine (FT3),free thyronine (FT4),thyroid-stimulating hormone receptor antibody (TRAb),thyroid peroxidase antibodies (TPOAb)and thyroglobulin antibody (TGAb)were compared between the two groups.A correlation analysis was progressed between the indicators of liver function and thyroid hormone.Results ①The incidence of hepatic dysfunction (at least one abnormal parameter)in the newly diagnosed patients with Graves hyperthyroidism was 71.6％ and the most familiar abnormal parameter was alanine transaminase (ALT) (37.7 ％).Altogether 61 patients (41.8 ％)had only one abnormal parameter in the hepatic dysfunction group and the most common abnormal parameter was alkaline phosphatase (ALP)(50.8％).②Compared with the normal group,hepatic dysfunction group had longer disease duration,higher serum FT3,FT4 and TRAb levels,but there were no significant differences in gender composition,age,thyroid weight,24 h-1nI intake rate,TPOAb,TGAb between the two groups.③A significantly positive correlation was found between the aspartate aminotransferase and FT3,the ALP and FT3,FT4,the total bilirubin and FT4,the direct bilirubin and FT3,FT4,respectively.Conclusions Hepatic dysfunction in newly diagnosed patients with Graves hyperthyroidism is very common and the most common abnormal parameters include ALT and ALP.The hepatic dysfunction is closely correlated with patients' disease duration,thyroid hormone and TRAb levels. Key words: Graves disease;  Hyperthyroidism;  Thyroid hormones;  Hepatic function