[Hypothalamo-pituitary-adrenal function in liver cirrhosis of viral etiology].
With the aim of evaluating the glucocorticoid function and the role of the adrenal gland in hypogonadism and feminization of cirrhotic patients, we examined 11 patients with virus-induced liver cirrhosis and 8 normal subjects as controls. In each subject serum levels of cortisol (C), progesterone (P), dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulphate (DHEAS), delta 4-androstenedione (A), estrone (E1), testosterone (T), luteinizing hormone (LH) were assayed in basal conditions and after adrenocorticotropic hormone (ACTH) stimulation. Serum levels of ACTH, C, E1, estradiol (E2), T were assayed in basal condition and after dexamethasone suppression test. Moreover, a circadian study of ACTH, C and corticosteroid-binding globulin (CBG) was performed, with blood samples drawn at 8:00 and 20:00 on two consecutive days. Our results demonstrate that in cirrhosis: 1) normal levels of C, when metabolism is altered and CBG levels are reduced, are maintained by inhibition of ACTH secretion; 2) circadian rhythmicity of the pituitary-adrenal axis is well preserved; 3) in non-alcoholic cirrhosis, too, there is a reduction of androgens (T, DHEA, DHEAS, A) and a rise of estrogens (E2 and, more markedly, E1) and P; 4) in cirrhotic men E1 is mainly of adrenal origin and contributes, through negative feedback on LH secretion, to low levels of T.
Demelia
L
L
Istituto di Clinica Medica, Università degli Studi di Cagliari.
Solinas
A
A
Poma
R
R
Vallebona
E
E
Pitzus
F
F
D000305:Adrenal Cortex Hormones / Q000097:blood; D000328:Adult; D012739:Gonadal Steroid Hormones / Q000097:blood; D006509:Hepatitis B / Q000150:complications*; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology*; D008103:Liver Cirrhosis / Q000097:blood / Q000209:etiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010913:Pituitary-Adrenal System / Q000503:physiopathology*; D011863:Radioimmunoassay
D000305:Adrenal Cortex Hormones; D012739:Gonadal Steroid Hormones
Studio della funzione ipotalamo-ipofiso-surrenalica nella cirrosi epatica di origine virale.