Liver, Portal, and Systemic Thyroid Hormone Alterations in End-Stage MASH: Distinct Diagnostic and Prognostic Roles for T3/rT3 Ratio and T4
End-stage metabolic dysfunction-associated steatohepatitis (MASH) features profound disruptions in thyroid hormone metabolism across liver, portal, and systemic compartments, with the hepatic T3 level and systemic T3/rT3 ratio serving as sensitive diagnostic biomarkers and systemic T4 correlating with disease severity.