Significance of total and free thyroid hormones in relation to serum proteins in chronic hepatitis B patients and normal controls

Hepatitis B destroys the liver cells. Proteins (albumin, pre albumin and thyroid binding globulin) produced by liver cells play an important role in metabolism and transport of thyroid hormones, therefore liver dysfunction is likely to disturb the transport of thyroid hormones resulting in disease. To determine the significance of thyroid hormones in relation to serum proteins in Chronic Hepatitis B patients. It was a cross sectional study conducted at National Health Research Complex (NHRC) and department of Gastroenterology Sheikh Zayed Medical Complex Lahore. One hundred Chronic Hepatitis B patients diagnosed by Polymerase Chain Reaction were matched with 100 healthy persons, served as control, were selected for total and free thyroid hormones using ELISA, while serum proteins were estimated spectrophotometrically. Serum total protein levels were within the normal range in both Chronic Hepatitis B patients and controls with mean value of 6.55 g/dl and 7.2 g/dl respectively, however serum albumin levels were lower in Chronic Hepatitis B patients (mean 2.69 g/dl) as compared to controls (mean 4.1 g/dl). Serum globulin was increased (4.09 g/dl) in patients as compared to controls (mean 3.1 g/dl).Albumin globulin ratio was <1(mean 0.73) in Chronic Hepatitis B patients while in controls it was >1(mean 13.5). Consequently, increased globulin resulted in more binding of T4 (mean 194 nmol/L) in Chronic Hepatitis B patients as compared to controls (mean 123 nmol/L). Conversion of T4 to T3 in Chronic Hepatitis B cases was also disturbed resulting in slight decrease of total T3 (mean 1.77 nmol/L) as compared to controls (mean 2.3 nmol/L). Free T3 (mean 3.56 pmol/L) and Thyroid Stimulating Hormone (mean 0.68 mIU/ml) also showed slight decrease when compared with controls (mean 4.5 pmol/L, mean 1.52 mIU/ml). FT4 remained within normal range in both the groups. In Chronic Hepatitis B related liver disease and cirrhosis, serum albumin levels go down while globulins go up and these changes alter the binding of thyroid hormones and Thyroid Stimulating Hormone resulting in disturbance in thyroid hormone levels. (author)