Serum total bilirubin and alanine transaminase levels in hyperthyroidism

Thyroid hormones are essential for normal growth, development and function of all tissues of the body by regulating basal metabolic rate of all cells, including hepatocytes. The present study was taken up to show the correlation between hyperthyroidism and hepatic dysfunction by measuring ALT and total bilirubin so that it helps in diagnosing patients of hyperthyroidism presenting with liver dysfunction or liver dysfunction as a manifestation of antithyroid drug treatment. 21 newly diagnosed hyperthyroid patients, 21 patients who are on treatment and Twenty one controls in the age group of 20-50yrs participated in the study. Serum T3, T4, TSH were analyzed by electrochemiluminescence, total bilirubin by diazzonium ion (blanked) and ALT (Alanine transaminase) by IFCC without PLP method. Kruskal Wallis test was done to compare T3, T4, TSH, total bilrubin and ALT levels among three groups. Post Hoc test was done for multiple comparisons between two groups. A significant difference for T3, T4, TSH (p <0.001) and total bilirubin values(p=0.012) was observed among the different groups. Post Hoc test for multiple comparisons between two groups revealed that total bilirubin levels were significantly high in newly diagnosed hyperthyroid patients and patients who are on treatment compared to controls. Six out of twenty one newly diagnosed hyperthyroid patients (29%) and five out of twenty one patients on treatment (24%) had total bilirubin values more >1mg/dl. ALT levels did not show statistically significant increase compared to controls. Conclusion: Assessing the liver function at the time of diagnosis and during treatment is necessary to monitor the hepatotoxic effects of hyperthyroidism so that an alternative treatment can be chosen for such patients.