Increase of serum estradiol in cirrhotic men treated by transjugular intrahepatic portosystemic stent shunt.
OBJECTIVE
Liver cirrhosis is frequently associated with sexual dysfunction and hormonal abnormalities. To evaluate the effect of portosystemic shunting on sex steroid serum concentrations, a prospective study was performed in cirrhotic patients treated consecutively and electively by transjugular intrahepatic portosystemic stent shunt (TIPS).


METHODS
In 27 patients with liver cirrhosis we measured serum levels of testosterone (T), sexual hormone binding globulin (SHBG), luteinizing hormone, follicle-stimulating hormone, dehydroepiandrosterone sulfate, androstenedione (A), estradiol (E2), 17-OH-progesterone and the T/SHBG ratio before and 3 months after TIPS.


RESULTS
In men (n = 17) 3 months after TIPS, A and E2 significantly increased, with mean serum levels rising from 4.4 +/- 2.5 to 5.6 +/- 2.9 ng/ml (P = 0.04) and from 27 +/- 9 to 40 +/- 19 pg/ml (P = 0.003), respectively. In contrast to A the increase of E2 persisted at 9 and 15 months after TIPS. Erectile dysfunction increased from 30% before TIPS to 70% after TIPS. In women (n = 10) A and E2 levels did not change significantly after TIPS.


CONCLUSIONS
TIPS aggravated hormonal dysbalance of sex steroids in favor of estrogens (hyperestrogenism) in men.
Nolte
W
W
Department of Medicine, Georg-August-Universität, Göttingen, Germany.
Schindler
C G
CG
Figulla
H R
HR
Wuttke
W
W
Hüfner
M
M
Hartmann
H
H
Ramadori
G
G
D000328:Adult; D000368:Aged; D000735:Androstenedione / Q000097:blood; D007172:Erectile Dysfunction / Q000097:blood / Q000209:etiology; D004958:Estradiol / Q000097:blood*; D005260:Female; D012739:Gonadal Steroid Hormones / Q000097:blood; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019168:Portasystemic Shunt, Transjugular Intrahepatic / Q000009:adverse effects*; D011446:Prospective Studies; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism
D012739:Gonadal Steroid Hormones; D012738:Sex Hormone-Binding Globulin; D000735:Androstenedione; D004958:Estradiol