Pituitary-testicular function in patients with alcoholic cirrhosis of the liver.
In forty-two patients with alcoholic liver cirrhosis and without recent alcohol ingestion the pituitary-testicular function was studied in an effort to relate the endocrine abnormalities with the degree of liver cell dysfunction, evaluated on a quantitative basis. Compared with values in twenty-one healthy controls, we found significantly elevated serum oestrone, oestradiol, follicle-stimulating hormone, luteinizing hormone and prolactin (P less than 0.01). Serum dehydro-epiandrosterone and dehydroepiandrosterone sulphate were significantly reduced in the cirrhotics (P less than 0.01), whereas serum testosterone was not significantly different from that in the controls. Raised levels of sex-hormone binding globulin were found in 71% (22/31) of the patients (median 8 x 10(-18) mol/l, range 3-17 x 10(-8) mol/l). The incidence of gynaecomastia (38%), cutaneous spiders (67%), testicular atrophy (24%) and reduced axillary hair (71%) was without significant relation to raised levels of sex-hormone binding globulin or progressively reduced liver function. In the presence of clinical or hormonal hypo-gonadism we found evidence of a state of primary hypogonadism together with an inadequate secretion of gonadotropins. The state of hyperoestrogenaemia and the concentration of gonadotropins were significantly correlated to the hepatic synthesis of coagulation factors.
D000328:Adult; D000368:Aged; D003687:Dehydroepiandrosterone / Q000097:blood; D004958:Estradiol / Q000097:blood; D004970:Estrone / Q000097:blood; D006062:Gonadotropins / Q000097:blood; D006177:Gynecomastia / Q000209:etiology; D006801:Humans; D007006:Hypogonadism / Q000209:etiology; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010902:Pituitary Gland / Q000503:physiopathology*; D011388:Prolactin / Q000097:blood; D012738:Sex Hormone-Binding Globulin / Q000032:analysis; D013737:Testis / Q000503:physiopathology*; D013739:Testosterone / Q000097:blood
D006062:Gonadotropins; D012738:Sex Hormone-Binding Globulin; D004970:Estrone; D013739:Testosterone; D003687:Dehydroepiandrosterone; D004958:Estradiol; D011388:Prolactin