Ophthalmopathy and other influential factors for liver abnormalities in patients with Graves’ disease

Abstract Background - Abnormal liver function tests (LFTs) is a common phenomenon in patients having Grave’s disease that tends to affect the treatment choice. Only few data on factors and biochemical indexes that contributes to such abnormalities in Graves patients are documented till date. Objective - The objective of this study was to explain the potent factors including ophthalmopathy for hepatic dysfunction evoked by Grave's disease alone. Method - A cohort of 263 patients who were newly diagnosed and untreated for Grave’s disease were studied. Clinical characteristics and all the biochemical values were collected and further analysis was done. These patients were further divided into two groups: group A with abnormal LFTs and group B with normal LFTs. Data were analyzed by using tests like the independent samples t- tests, chi-square tests and logistic regression tests. Result - Among them, 175(66.53%) were found to have at least one LFT abnormality. The frequencies of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), gamma-glutamyl transpeptidase (γ-GGT), total bilirubin (TBIL) and direct bilirubin (DBIL) were 54.9% (96/175), 29.7% (52/175), 29.7% (52/175), 38.3% (67/175), 33.1% (58/175) and 34.3% (60/175) respectively of which ALT was the commonest abnormality In the univariate analysis, group A patients had higher FT3 and FT4 than group B while group B had higher white blood cells (WBC) count mainly granulocyte % and ophthalmopathy than group A. Results of multivariate logistic regression identified FT3 and ophthalmopathy as independent factors predicting abnormal LFTs [odds ratio (OR) = 1.062, 95% confidence interval (CI) = 1.028–1.096 and OR = 0.355, 95% CI = 0.195–0.647 respectively] . Conclusion - While FT3 value > 5.70 pmol/L showed consistent association with liver function abnormality in patients with Graves, in contrast, ophthalmopathy showed inverse association with liver function abnormalities.