Steroid Hormones and Their Binding in Plasma of Male Patients With Fatty Liver, Chronic Hepatitis and Liver Cirrhosis

Abstract

Oestrone (E1), oestradiol (E2), testosterone (T), androstenedione (A) and cortisol (F) as well as LH and the percentage of binding of E1, E2, T and F in plasma were measured and compared in normal young and old male subjects and in male patients with fatty liver, chronic hepatitis and cirrhosis of the liver. The alterations seen were most marked in the cirrhotic patients, but were partially also found in patients with fatty liver and in normal old subjects: a definite increase in E1, a smaller increase in E2, a decrease in T and a rise in LH. F remained unchanged. The ratios of E2/T and E1/T were higher in cirrhotic patients than in healthy young subjects. As the percentage of bound T in plasma rose, the oestrogen/androgen imbalance was greater in patients with liver disease and in old subjects than the ratio of total hormone plasma concentration indicates. The biological relevance of the extremely high E1 plasma concentrations in patients with cirrhosis of the liver is not known. It is suggested that the combination of elevated E1 and E2 and reduced T, which is strongly bound by increased sexual hormone binding globulin (SHBG) may be responsible for gynaecomastia and hypogonadism in chronic liver diseases. As similar alterations of steroid plasma concentrations and their binding to plasma proteins are found both in patients with liver disease and in old men, these changes may be caused by the same mechanism: namely an altered liver function.

Influence of the Maturity of the Vaginal Epithelium upon the Absorption of Vaginally Administered Estradiol-17β and Progesterone in Postmenopausal Women

“…A sim ilar association between vaginal hormone cytology and serum 'total' estrogens, i.e., E[ + E2, in postmenopausal women has previously been shown by Benjamin and Deutsch [3]. These findings further confirm the superior ity of E| or E| + E2 assay compared to E2 when studying the estrogen status in subjects with mainly extragonadal estrogen sources, i.e., postmenopausal women and men [7,8],…”

Alcohol-Induced Ovarian Failure in the Rat

“…Chronic alcoholic men have normal to moderately elevated plasma gonadotropin concentrations, often in the face of markedly decreased plasma testosterone concentrations (1,6,42,56,57,60). This has been interpreted to suggest the presence of diminished hypothalamic-pituitary function in such men, and this suggestion has been confirmed by studies establishing that chronic alcoholic men have reduced plasma gonadotropin responses to clomiphene and luteinizing hormone releasing factor (6,7).…”

“…Therefore, the hyperestrogenization and hypoandrogenization of male alcoholics are, in part, derivative effects of alcohol-induced liver disease. Thus, the presence of decreased hepatocellular function and portal-systemic shunting of blood permits increased availability of androstenedione at sites peripheral to the liver for conversion to estrone (39)(40)(41)(42)(43)(44). Similarly, accelerated hepatic metabolism of testosterone and increased hepatic conversion of testosterone to estradiol are thought to occur in men with alcoholic liver disease although overall testosterone clearance is retarded in men with cirrhosis (41).…”

“…Human male alcoholics with markedly reduced testosterone levels have increased plasma levels of estrone (43,54,55), and some authors report increased plasma levels of estradiol as well (56,57). This estrone is derived primarily by peripheral conversion of androstenedione which arises from the adrenal gland (40)(41)(42)(43)(44). Although specific studies have not been performed to confirm this point in our model, we propose that the increased levels of estrone in our alcohol-fed and pair-fed isocaloric control female rats are derived similarly from androstenedione of adrenal origin.…”

Testosterone: a metabolic hormone in health and disease

“…Only one, albeit large-scale, population-based cross-sectional study reports an association between low serum testosterone concentrations and hepatic steatosis in men (Völzke et al 2010). Two smaller studies report contrasting results in patients with hepatic steatosis as one reported low serum concentrations of testosterone and the other reported no significant differences in serum levels (Kley et al 1975, Myking et al 1987. Another study demonstrated through the generation of a hepatic AR knockout mouse model that a high-fat diet induced hepatic steatosis and insulin resistance in male but not in female mice (Lin et al 2008).…”