The Relationship Between Low T3 and Disease Severity in Patients With Acute Pancreatitis

Abstract

Abstract Sick euthyroid syndrome is a change in thyroid hormones because of functional deterioration in the hypothalamic-pituitary-thyroid axis in critically ill patients. We aimed to show that deterioration in thyroid function tests can be used as an indicator of severity and prognosis in pancreatitis despite a healthy thyroid gland. The study was designed as retrospective, single center. Patients diagnosed with acute pancreatitis between May 2020 and June 2021 were evaluated. Acute pancreatitis was classified according to the 2012 revised Atlanta criteria. Patients were categorised as sick euthyroid syndrome and euthyroid group and compared in terms of biochemical parameters and, scorings such as Ranson 0, Ranson 48, Glasgow, Balthazar, Bisap. A total of 152 patients were included in the study. Eighty-three patients (54%) were euthyroid. Sixty-nine patients (46%) had sick euthyroid syndrome with low serum free T3 level and high/normal TSH level. Free T3 was lower in the sick euthyroid syndrome group than in the euthyroid group. (1.5 ± 0.04 vs 2.6 ± 0.04, respectively p < 0.0001) In the sick euthyroid syndrome group, Ranson 0 (1.5 ± 0.1 vs 0.9 ± 0.1 p = 0.001), Ranson 48th Hour (1.8 ± 0.1 vs 1.1 ± 0.1 p < 0.0001 ), Glasgow (2.4 ± 0.2 vs 1.3 ± 0.1 p < 0.0001), Atlanta (p = 0.007) and Balthazar (2.1 ± 0.1 vs 1.4 ± 0.1) p = 0.001) scores were found to be significantly higher than the euthyroid group. Sick euthyroid syndrome gives an idea about the prognosis in acute pancreatitis. We showed that free T3 value is a significant parameter that may be used to indicate the prognosis of acute pancreatitis.