In order to clarify an alteration in thyroid functions in patients with chronic liver diseases, serum total and free thyroxine (T
4, FT
4), total and free triiodothyronine (T
3, FT
3), total reverse T
3 (rT
3), thyrotropin (TSH), thyroxine-binding globulin (TBG) concentrations, and T
3uptake (T
3U) were measured by radioimmunoassays in 53 patients with chronic hepatitis (CH), 24 patients with compensated liver cirrhosis (LC), 17 patients with hepatocellular carcinoma associated with LC (HCC), and 40normal subjects. Serum T
4, T
3, and rT
3in CH, and serum rT
3in HCC were significantly increased, while serum T
4in LC and serum T
3in HCC were significantly decreased. Serum TBG was increased and T
3U was decreased in these patients. Serum TBG in CH and LC correlated positively with transaminase, and inversely with prothrombin time. FT
4 and T
4/TBG ratios in CH and LC and FT
3and T
3/TBG ratios in LC and HCC were significantly decreased. Although T
4/TBG ratios in HCC and T
3/TBGratios in CH were significantly decreased, FT
4in HCC and FT
3 in CH were not decreased. The ratio of rT
3/T
3in CH and LC correlated with various liver function tests. FT
3 in LC and HCC correlated inversely with BSP (45') and positively with KICG.No differences in serum TSH values were found between chronic liver diseases and normal subjects. From these results, it was concluded that the thyroid functions in patients with chronic liver diseases were affected by thedecrease in serum thyroxine, elevated serum TBG, the degree of which is in proportion to that of the liver cell damage, and impaired peripheral conversionof T
4to T
3, the degree of which is in proportion to that of the hepatic dysfunction.
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