Objective To investigate the clinical situation and risk factors of hyperthyroidism-induced liver injury in patients with newly diagnosed Graves disease.Methods The general clinical data and laboratory test results of patients with Graves disease initially diagnosed in Affiliated Hospital of Qingdao University from January 2017 to January 2022 were collected,including gender,age,course of Graves disease,smoking history,drinking history,family history,past disease history,thyroid function and antibody levels,and liver function were used,the risk factors of hyperthyroidism-induced liver injury in patients with newly diagnosed Graves disease was compared.Data analysis was performed using independent samples t test,chi-square test,and multivariate Logistic regression analysis.Results A total of 261 patients were collected,included 66 males and 195 females,with an average age of(38.63±12.68)years.The incidence of hyperthyroidism-induced liver injury in newly diagnosed Graves disease patients was 45.59%,and the most common abnormal liver function was elevated alanine aminotransferase(ALT),which accounted for 29.89%.According to whether the patients had hyperthyroidism liver injury or not,there were 142 cases in the normal liver function group and 119 cases in the abnormal liver function group.Univariate analysis showed that the age,female proportion,new atrial fibrillation rate,free triiodothyronine 3 (FT3),free tyroxine 4(FT4),thyroid peroxidase antibody(TPOAb),thyrotropin receptor antibody(TRAb)levels in the abnormal liver function group were higher than those in the normal liver function group,and the differences were statistically significant(P＜0.05).There were no significant differences in the course of Graves' disease,smoking history,drinking history,family history,diabetes history,the levels of thyroid stimulating hormone(TSH)and thyroglobulin antibody(TGAb)between the two groups (P＞0.05).The Logistic regression model showed that the results of multivariate analysis showed that age(β=0.039,OR=1.040,95% CI: 1.016-1.065),FT4(β=0.019,OR=1.019,95% CI: 1.019-1.003),TPOAb(β=0.006,OR=1.006,95%CI:1.004-1.009),TRAb (β=0.030,OR=1.031,95%CI:1.001-1.061)were an independent risk factor for hyperthyroidism-induced liver injury in patients with newly diagnosed Graves disease.Conclusion Among the newly diagnosed patients with Graves disease,those with older age and higher levels of FT4,TPOAb and TRAb are more likely to develop hyperthyroidism-induced liver injury.