Lipids & metabolic liver disease
Liver, Portal, and Systemic Thyroid Hormone Concentrations in End-Stage MASH Reveal Distinct Roles for T3/Reverse T3 (rT3) Ratio and T4
Authors' conclusion
This study characterized TH metabolism in human end-stage MASH, which provides direct tissue-level evidence supporting intrahepatic hypothyroidism. The systemic T3/rT3 ratio and hepatic T3 potently discriminate MASH from healthy liver, while total systemic T4 tracks disease severity within established cirrhosis.
Study context
- Population
- Patients with end-stage MASH (cirrhosis) undergoing liver transplantation and living liver donors; liver tissue, portal and systemic plasma collected intraoperatively
- Participants
- 12 vs 12
- Exposure
- MASH cirrhosis vs healthy living liver donors
- MASH cirrhosisn = 12
- Healthy controlsn = 12reference
- Outcome
- Total T4, T3 and rT3 in liver, portal and systemic plasma; disease discrimination
Methodological detailsTotal T4, T3 and rT3 quantified by liquid chromatography-tandem mass spectrometry
- Total T4, T3 and rT3 quantified by liquid chromatography-tandem mass spectrometry
Main finding
As reported in the abstract
T3/rT3 ratio markedly suppressed
−65% to −83%
Disease discrimination, hepatic T3 (strongest): BMI-adjusted OR
0.009
95% CI 0.001–0.190p < 0.001
Disease discrimination, systemic T3/rT3 ratio: BMI-adjusted OR
0.045
95% CI 0.001–0.328p < 0.001
Observational data: associations, not effects.
Further findings
Systemic T4 vs disease severity within MASH cohort
- Correlation with MELD score (r)
- −0.867, adjusted p = 0.005
- Correlation with Child-Pugh score (r)
- −0.760, adjusted p = 0.033
- Multivariable regression independent of BMI, standardized β
- −0.744, adjusted p = 0.004
Original publication
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