Male hypogonadism in cirrhosis and after liver transplantation.
Liver is deeply involved in the metabolism of proteins, hormones, enzymes, cytokines, as well as in sex hormones catabolism. Gonadal function requires a normal liver function, and it is well known that clinical signs of hypogonadism are common in patients with liver cirrhosis. Few studies have focused on hypothalamic- pituitary-gonadal alterations in male cirrhotic patients or after orthotopic liver transplantation (OLT). The pathogenesis of hypogonadism in cirrhotic patients is complex and not well explained. It involves both a gonadal and a hypothalamic- pituitary dysfunction. After OLT the hypothalamic-pituitary-gonadal function partially improves, showing that the hepatic dysfunction before OLT is deeply involved in its pathogenesis. After OLT some alterations persist in some patients, both because of pre-existing gonadal alterations (toxic-metabolic damage) and immunosuppressive pharmacological side effects. Further studies will explain the relationship between hypogonadism and OLT outcome, and the role of androgen therapy in hypogonadism after OLT, in the early months and in the long term.
Foresta
C
C
Department of Histology, Microbiology and Medical Biotechnologies, Centre for Male Gamete Cryopreservation, University of Padua, 35128 Padua, Italy. carlo.foresta@unipd.it
Schipilliti
M
M
Ciarleglio
F A
FA
Lenzi
A
A
D'Amico
D
D
D005298:Fertility / Q000502:physiology; D006066:Gonads / Q000503:physiopathology; D006801:Humans; D007006:Hypogonadism / Q000209:etiology*; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology; D007165:Immunosuppression Therapy / Q000009:adverse effects; D008103:Liver Cirrhosis / Q000150:complications* / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D016031:Liver Transplantation / Q000009:adverse effects; D008297:Male; D012738:Sex Hormone-Binding Globulin / Q000032:analysis; D012725:Sexual Behavior / Q000502:physiology
D012738:Sex Hormone-Binding Globulin