Hypothalamic‐pituitary‐testicular function in end‐stage non‐alcoholic liver disease before and after liver transplantation

Handelsman, David J.; Strasser, Simone I.; McDonald, Jenny; Conway, Ann J.; McCaughan, Geoffrey W.

doi:10.1111/j.1365-2265.1995.tb02040.x

Cited by 86 publications

(75 citation statements)

References 37 publications

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“…In addition, the increase in SHBG leads to a stronger binding with testosterone (8,13) . In cirrhotic patients occur an increase in the peripheral conversion of androgens into estrogens (4,6,7) and a decrease in the liver depuration of estrogens.…”

Section: Resultsmentioning

confidence: 99%

“…Testosterone serum level is lower than in normal patients (5,7,9) which masks a marked fall in the non-protein-bound (biologically active) fraction of the hormone due to a large increase in the sex hormone-binding globulin (SHBG) (3,7,10) which binds testosterone with a high affinity. Most circulating testosterone is bound SHBG and only the small proportion in the free form is biologically active (8,13) . Our prospective study has shown that serum levels of FT increased in A group (MELD<18) after OLT (P<0.05) (13) and we did not find significantly changes in total testosterone serum levels after transplantation (P = 0.73).…”

Section: Resultsmentioning

confidence: 99%

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Testosterone Changes in Patients With Liver Cirrhosis Before and After Orthotopic Liver Transplantation and Its Correlation With Meld

Nitsche

Coelho

Freitas

et al. 2014

Arq. Gastroenterol.

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Context Hypogonadism is a common clinical situation in male patients with liver cirrhosis. Objectives The aim of the present study was to evaluate the effects of orthotopic liver transplantation on testosterone, free testosterone and sex hormone-binding globulin in male with advanced liver disease and also to determine the relationship of these changes with Model for End-stage Liver Disease (MELD) score. Methods In a prospective study, serum levels of testosterone, free testosterone and sex hormone-binding globulin of 30 male adult patients with end-stage liver disease were measured 2 to 4 hours before and 6 months after orthotopic liver transplantation. Results Total testosterone levels increased after orthotopic liver transplantation and the number of patients with normal testosterone levels increased from 18 to 24. Free testosterone mean level in the pre-transplant group was 7.8 pg/mL and increased to 11.5 pg/mL (P = 0.10) and sex hormone-binding globulin level decreased after orthotopic liver transplantation returning to normal levels in MELD ≤18 - group (A) (P<0.05). Conclusions Serum level changes of testosterone, free testosterone and sex hormone-binding globulin are more pronounced in cirrhotic males with MELD ≤18. Serum levels of testosterone and free testosterone increase and serum levels of sex hormone-binding globulin decrease after orthotopic liver transplantation.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Testosterone Changes in Patients With Liver Cirrhosis Before and After Orthotopic Liver Transplantation and Its Correlation With Meld

Nitsche

Coelho

Freitas

et al. 2014

Arq. Gastroenterol.

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“…As a matter of fact, patients affected with liver cirrhosis show FSH and LH levels only slightly increased, but certainly not so high as expected because of a severe lack of circulating sex hormones. As testosterone is metabolized to estrogen, a long duration of hypogonadism in men is often associated with a reduction in circulating estrogens, and consequent reduced bone turnover, with decreased osteosynthesis [7]. Since these endocrine alterations described above play a heavy clinical role in male, it is clear that most studies on this aspect have been conducted in cirrhotic males.…”

Section: Pathophysiology Of Osteoporosis In Chronic Liver Diseasesmentioning

confidence: 99%

Osteodystrophy in chronic liver diseases

et al. 2012

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Osteoporosis and osteomalacia are, to date, among the most common metabolic diseases in the world. Lately, an association between metabolic bone diseases and chronic liver disease has been increasingly reported, inducing many authors to create a new nosographic entity known as 'hepatic osteodystrophy. ' The importance of such a condition is further increased by the morbidity of these two diseases, which greatly reduce the quality of life because of frequent fractures, especially vertebral and femoral neck ones. For this reason, early identification of high-risk patients should be routinely performed by measuring bone mass density. The explanation for the association between bone diseases and chronic liver disease is still uncertain, and involves many factors: from hypogonadism to use of corticosteroid drugs, from genetic factors to interferon therapy. To date, few studies have been conducted, and all with a small number of patients to establish definitive conclusions about the possible treatment, but some evidence is beginning to emerge about the safety and efficacy of bisphosphonates.

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“…The production of testosterone by cirrhotic individuals is, on average, 25% of that found in normal individuals (3). Low levels of this hormone are already noted even in ChildPugh A cirrhotic patients, and the decline is directly proportional to the degree of liver failure (4,5).…”

Section: Introductionmentioning

confidence: 99%

Male gonadal function, prolactin secretion and lactotroph population in an experimental model of cirrhosis

Gonzáles

Rhoden

Luz

et al. 2007

Braz J Med Biol Res

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Liver cirrhosis, a highly prevalent chronic disease, is frequently associated with endocrine dysfunctions, notably in the gonadal axis. We evaluated lactotroph population by immunohistochemistry, gonadotropins and prolactin by immunoradiometric assay and testosterone and estradiol by radioimmunoassay in adult male Wistar rats with cirrhosis induced by carbon tetrachloride. No significant difference in mean ± SEM percentages of lactotrophs was found between cirrhotic animals and controls (N = 12, mean 18.95 ± 1.29%). Although there was no significant difference between groups in mean serum levels of prolactin (control: 19.2 ± 4 ng/mL), luteinizing hormone (control: 1.58 ± 0.43 ng/mL), follicle-stimulating hormone (control: 19.11 ± 2.28 ng/mL), estradiol (control: 14.65 ± 3.22 pg/mL), and total testosterone (control: 138.41 ± 20.07 ng/dL), 5 of the cirrhotic animals presented a hormonal profile consistent with hypogonadism, all of them pointing to a central origin of this dysfunction. Four of these animals presented high levels of estradiol and/or prolactin, with a significant correlation between these two hormones in both groups (r = 0.54; P = 0.013). It was possible to detect the presence of central hypogonadism in this model of cirrhotic animals. The hyperestrogenemia and hyperprolactinemia found in some hypogonadal animals suggest a role in the genesis of hypogonadism, and in the present study they were not associated with lactotroph hyperplasia.

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Hypothalamic‐pituitary‐testicular function in end‐stage non‐alcoholic liver disease before and after liver transplantation

Cited by 86 publications

References 37 publications

Testosterone Changes in Patients With Liver Cirrhosis Before and After Orthotopic Liver Transplantation and Its Correlation With Meld

Testosterone Changes in Patients With Liver Cirrhosis Before and After Orthotopic Liver Transplantation and Its Correlation With Meld

Osteodystrophy in chronic liver diseases

Male gonadal function, prolactin secretion and lactotroph population in an experimental model of cirrhosis

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