Hypothalamic-pituitary-gonadal function in men with liver cirrhosis before and after liver transplantation

Abstract

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 Results ResultsResults 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). Conclusion Conclusion Conclusion Conclusion Conclusion: 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.

Effects of liver transplantation on endocrine function: a systematic review

“…Estradiol values were decreased after LT in all of the six studies that reported these values . The estradiol reduction ranged from 25.0 to 57.6% .…”

“…. The analysis included ten prospective studies , five retrospective studies and six cross‐sectional studies . Healthy controls were used for comparison in five studies .…”

“…The largest post-transplant elevations in testosterone and free testosterone were 90% (14) and 920% (16) of the pretransplant values respectively. Estradiol values were decreased after LT in all of the six studies that reported these values (10,13,15,16,18,31). The estradiol reduction ranged from 25.0 (15) to 57.6% (31).…”

“…Prolactin was reduced after LT in four of five studies (13,16,18,19,31), with decreases ranging from 33.0 (18) to 49.1% (31). Follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels were increased after LT in six of eight studies (12-16, 18, 20, 21, 31).…”

Sexualidade de candidatos e receptores de transplante de fígado: revisão integrativa da literatura

“…A doença hepática terminal afeta a homeostase no eixo hipotalâmico-hipofisáriogonadal, desencadeando o hipogonodismo, determinado pelo nível baixo de testosterona e nível alto de estrogênio (ZACHARIAS et al, 2014). A fisiopatologia do hipogonodismo em pacientes com doença hepática terminal é complexa, podendo ocorrer por dano no metabolismo, principalmente em pessoas com cirrose por etiologia alcoólica, uma vez que o álcool é responsável por causar insuficiência gonodal primária (BANNISTER et al, 1987).…”