Association of energy metabolism with serum thyroid hormone levels in patients with liver failure and their impact on prognosis
10.3969/j.issn.1001-5256.2023.01.020
- VernacularTitle:肝衰竭患者能量代谢与血清甲状腺激素水平的相关性及其对预后的影响
- Author:
Xing LIU
1
;
Ming KONG
2
,
3
;
Xin HUA
4
;
Yinchuan YANG
2
;
Manman XU
2
;
Yanzhen BI
5
;
Lu LI
2
;
Zhongping DUAN
2
,
4
;
Yu CHEN
2
,
4
Author Information
1. Department of Infectious Disease, Linyi People's Hospital, Linyi, Shandong 276000, China
2. Fourth Department of Liver Disease, Beijing YouAn Hospital, Capital Medical University, Beijing 100069, China
3. Beijing Municipal Key Laboratory of Liver Failure and Artificial Liver Treatment Research, Beijing 100069, China
4. Department of Clinical Nutrition, Beijing YouAn Hospital, Capital Medical University, Beijing 100069, China
5. Department of Infectious Disease, Qingdao Municipal Hospital, Qingdao, Shandong 266011, China
- Publication Type:Original Articles_Other Liver Disease
- Keywords:
Liver Failure;
Energy Metabolism;
Thyroxine;
Prognosis
- From:
Journal of Clinical Hepatology
2023;39(1):137-141
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the predictive value of the model for end-stage liver disease (MELD) score, energy metabolism and serum thyroid hormone levels on the severity and prognosis of patients with liver failure and their correlation. Methods This study collected clinicopathological data from 60 liver failure patients, e.g., end-stage liver disease (MELD) score, energy metabolism, and serum thyroid hormone levels. The χ 2 test was performed to analyze the categorical variables, while the Mann-Whitney U test and independent sample t test were performed to assess the continuous variables between the two groups. Spearman correlation coefficient test was used to evaluate correlation of each index. The receiver operating characteristic (ROC) curve was used to analyze the optimal cut-off points of serum total triiodothyronine (TT3) and free triiodothyronine (FT3) levels in predicting prognosis of the patients. Results The rates of low TT3 and FT3 levels in liver failure patients were 78.2% and 69.1%, respectively, whereas the low TT3 rates were 95.2% and 67.6% and the low FT3 rates were 90.5% and 55.9% in survival and non-survival groups of patients, respectively (both P < 0.05). Moreover, the MELD score was significantly higher in the non-survival patients than in survival patients [26.0(21.0-29.0) vs 21.0 (19.0-24.0), Z =-3.396, P =0.001], while TT3 and FT3 levels were significantly lower in the non-survival patients than in the survival patients [0.69(0.62-0.73) vs 0.83(0.69-0.94) and 2.17(1.99-2.31) vs 2.54(2.12-2.86), respectively; Z =-2.884、-2.876, all P < 0.01]. The MELD score was negatively associated with serum TT3, FT3, and thyroid stimulating hormone (TSH) levels and the respiratory quotient (RQ) ( r =-0.487、-0.329、-0.422、-0.350, all P < 0.01), whereas the RQ was associated with serum TT3 and FT3 levels ( r =0.271、0.265, all P < 0.05). The optimal cutoff values in predicting the severity and survival of patients was 0.75 nmol/L and 2.37pmol/L with the sensitivity values of 67.6% and 64.7% and the specificity of 90.5% and 81.0%, respectively. Conclusion Abnormal thyroid hormone levels and low respiratory quotient could be used to predict the severity and prognosis of patients with liver failure.
