Hypothalamic-pituitary-gonadal function in men with liver cirrhosis before and after liver transplantation.
OBJECTIVE
To evaluate the influence of end-stage liver disease and orthotopic liver transplantation in the pituitary function and hormone metabolism before and after liver transplantation.


METHODS
In a prospective study, serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2) and prolactin (PRL) of 30 male patients with cirrhosis were determined two to four hours before and six months after liver transplantation. The results were compared according to the Model for End-stage Liver Disease (MELD).


RESULTS
male patients with liver cirrhosis have hypogonadism. FSH was normal, but inappropriately low due to androgen failure; E2 and PRL, on their turn, were high. After liver transplantation, FSH and LH levels increased (p < 0.05), whereas E2 and PRL normalized (p < 0.05). The MELD score did not influence changes in FSH, PRL and LH, however, the more severe the cirrhosis was, the more significant was the normalization of E2 (p = 0.01).


CONCLUSIONS
Patients with cirrhosis and male hypogonadism have inappropriately normal levels of FSH and LH, associated with an increase in E2 and LRP. After liver transplantation, FSH and LH increased, while E2 and PRL returned to normal. Changes in E2 levels were most pronounced in patients with MELD > 18. The severity of cirrhosis had no influence on FSH, PRL and LH.
Department of Surgery of the Digestive System, Clinics Hospital, Federal University of Paraná, Curitiba, Paraná, Brazil.
Bruno T
BT
Zacharias
Federal University of Paraná.
Julio C U
JC
Coelho
Federal University of Paraná.
Mônica B
MB
Parolin
Department of Surgery of the Digestive System, Clinics Hospital, Federal University of Paraná, Curitiba, Paraná, Brazil.
Jorge E F
JE
Matias
Department of Surgery of the Digestive System, Clinics Hospital, Federal University of Paraná, Curitiba, Paraná, Brazil.
Alexandre C T de
AC
Freitas
Federal University of Paraná.
José Luiz de
JL
Godoy
D004958:Estradiol / Q000097:blood; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology*; D008103:Liver Cirrhosis / Q000097:blood / Q000503:physiopathology* / Q000601:surgery*; D016031:Liver Transplantation; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D008875:Middle Aged; D011388:Prolactin / Q000097:blood; D011446:Prospective Studies; D013737:Testis / Q000503:physiopathology*
D004958:Estradiol; D011388:Prolactin; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone