Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0023890 (cirrhosis)
 42,195 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We measured serum sex hormone-binding globulin (SHBG) using a radioimmunoassay developed by us, testosterone (T), estradiol (E2), free T and free E2 in 50 male patients with non-alcoholic liver cirrhosis (compensated: 30, decompensated; 20) and age-matched healthy male subjects, SHBG was significantly increased in patients with liver cirrhosis compared with healthy subjects. The high serum SHBG level in male compensated cirrhotic patients tended to decrease with progression to the decompensated state. Serum cholinesterase showed a positive correlation with SHBG in liver cirrhosis. Serum free T and the T/SHBG ratio decreased, while serum E2, free E2, and the E2/T and the free E2/free T ratios increased in liver cirrhosis, resulting in estrogen predominance and feminization of male patients. These changes were more marked in decompensated than compensated liver cirrhosis. An increased free E2/free T ratio was observed in patients with gynecomastia, palmar erythema or vascular spider. The T/SHBG ratio showed a positive correlation with serum free T, suggesting that it can be used as a free T index in liver cirrhosis. From these observations, it is suggested that serum SHBG plays an important role, by regulating the serum free T level in the occurrence of feminization in male patients with non-alcoholic liver cirrhosis.
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PMID:Mechanism of feminization in male patients with non-alcoholic liver cirrhosis: role of sex hormone-binding globulin. 191 51

Blood-free testosterone indices were measured among 28 normal men (age; 24-48 yrs.), 20 normal women (20-36 yrs.), 18 pregnant women (22-31 yrs.), 17 males with hypogonadism (23-56 yrs.), 17 males with chronic hepatitis (20-42 yrs.), 24 males with liver cirrhosis (29-68 yrs.), 34 males with hyperthyroidism (20-42 yrs.) and 7 hirsute women (18-31 yrs.), and these were compared with the plasma concentrations of free testosterone. The testosterone index was obtained by multiplying the plasma concentration of testosterone by the percent of sex hormone-binding globulin (SHBG), non-bound testosterone precipitated by dextran-coated charcoal. A significant increase of plasma testosterone was observed in patients with chronic hepatitis (p less than 0.001) and hyperthyroidism (p less than 0.001) as compared with normal men and was also observed in pregnant (p less than 0.01) and hirsute women (p less than 0.01) as compared with normal women. The close negative correlation between plasma levels of testosterone and the percent of SHBG non-bound testosterone (r = -0.87, n = 79, p less than 0.001) was observed among normal men, male patients with chronic hepatitis and hyperthyroidism. The sex hormone binding capacity was increased from two to three fold in patients with chronic hepatitis and hyperthyroidism. The patients with compensated liver cirrhosis had increased plasma testosterone and a decreased percent of SHBG non-bound testosterone, and those with decompensated liver cirrhosis had decreased plasma testosterone and a normal percent of SHBG non-bound testosterone. The plasma concentration of free testosterone was normal in patients with chronic hepatitis and hyperthyroidism. It decreased in pregnancy (p less than 0.01) and increased in hirsute women (p less than 0.01). The blood free testosterone index was slightly high in one third of the patients with chronic hepatitis and hyperthyroidism as compared with that in normal men. However, a close correlation of the percent of SHBG non-bound testosterone and fractional free testosterone (%) measured by equilibrium dialysis (gamma = 0.82, p less than 0.001) was obtained in all subjects (n = 170). These data suggest that the blood free testosterone index parallels the plasma concentration of free testosterone and is useful to evaluate the status of androgenicity.
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PMID:[Free testosterone index: comparison with plasma free testosterone]. 243 Aug 42

In elderly males hormonal changes occur, that are believed to cause benign prostatic hyperplasia (BPH). These are decreased testosterone production, an increased testosterone SHBG and a slightly increased estradiol production. Liver cirrhosis in males causes similar endocrine changes. We carried out a post mortem study evaluating the prostates of 51 men who died with liver cirrhosis compared with a similar group without any hepatic disease. The occurrence of BPH in cirrhotic subjects was diminished and delayed compared to total population. Furthermore in cirrhotic men BPH is more common as early nodular hyperplasia (early stage) or stromal hyperplasia (suggesting estrogenic prevalence), while in the general population stromal and epithelial hyperplasia (androgenic stimulation), were almost equally present.
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PMID:Correlation between liver cirrhosis and benign prostatic hyperplasia: a morphological study. 244 12

The contribution of diabetes and cirrhosis to sexual dysfunction and hypogonadism was evaluated by two-way analysis of variance in a group of 30 men with idiopathic hemochromatosis. The prevalence of severe sexual dysfunction was significantly higher in men with hemochromatosis than in a control group matched for prevalence of diabetes and age (P less than 0.001). In both controls and hemochromatosis patients the presence of diabetes was significantly associated with sexual dysfunction (P less than 0.005), but the more severe symptoms in the hemochromatosis patients were related to the additive effects of hypoandrogenism (P less than 0.01). Sexual dysfunction was a common early complaint in hemochromatosis patients, but these symptoms were frequently overlooked, leading to diagnostic delay. Mean testicular volume was a useful measure of gonadal status, being significantly correlated with indices of serum free testosterone (rs = 0.83; P less than 0.01) and LH (rs = 0.71; P less than 0.001). The presence of cirrhosis did not contribute significantly to symptomatology, but had an effect independent of and additive to hypogonadotropic hypogonadism in reducing serum free testosterone (P less than 0.02) and estradiol (P less than 0.002), an effect apparently mediated through central rather than testicular mechanisms. Hypoandrogenism was associated with an increase in serum sex hormone-binding globulin (SHBG) concentrations (P less than 0.005), but cirrhosis also had an independent effect in raising SHBG (P less than 0.005), which could not be accounted for by changes in circulating sex hormone concentrations. Thus, the evaluation of sexual dysfunction or hypogonadism in men with hemochromatosis requires consideration of the effects of both diabetes and cirrhosis. Because of the greater variance in SHBG some estimate of free testosterone rather than total testosterone is preferable.
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PMID:Hypogonadism and sexual dysfunction in hemochromatosis: the effects of cirrhosis and diabetes. 273 93

Testosterone (T) is a protein-bound substance, the hepatic extraction of which largely exceeds the free plasma fraction. In this study we attempted to determine if the dissociation of T from plasma proteins is the limiting factor for testosterone hepatic uptake in patients with cirrhosis. For this purpose we measured the hepatic uptake of T and the peripheral plasma concentrations of the different fractions of the hormone (total, free, albumin-bound, and sex hormone-binding globulin (SHBG)-bound) in 12 men with alcoholic cirrhosis. The hepatic extraction of T (mean = 42%) greatly exceeded the non-SHBG-bound fraction of T (free T plus albumin-bound T: mean = 13%). Thus, a substantial amount of SHBG-bound T must have entered the liver. A theoretical extraction ratio was calculated based upon the dissociation rate constants of T from albumin and SHBG and upon an estimate of sinusoidal transit time of plasma through the liver. The similarity between the measured and expected values indicates that the limiting step in hepatic uptake of T might be SHBG binding.
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PMID:Effect of protein binding on testosterone extraction by human cirrhotic liver: evidence for a dissociation-limited uptake. 273 95

In the present paper the following non-endocrine internal diseases are discussed: liver cirrhosis, diabetes, chronic renal failure and morbus Crohn. In alcoholic liver patients under fifty, hypospermia and oligozoospermia can be observed. The hormone assays showed moderately increased FSH- and LH-values in the serum; prolactin, testosterone and estradiol remained normal. An increased binding of testosterone to SHBG is supposed, and the androgen deficiency symptoms are considered to be due to the elevated binding of testosterone to SHBG. The other non-endocrine internal diseases and drug-groups (cytostatics, steroids, neuroleptics, antihypertensives, antiarrhythmics, nitrofurans, levamisole, fungicides and salazosulfapyridine) are reviewed on the basis of literature. After the administration of 1 g per day of cimetidine for four weeks in patients under fifty with duodenal ulcer, notable andrological side effects were not revealed by neither clinical nor hormone examinations.
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PMID:[Andrological abnormalities in internal diseases and following drug therapy]. 311 48

The MCR of testosterone is decreased but the MCR of estradiol is unchanged in men with cirrhosis and elevated serum sex hormone-binding globulin (SHBG) concentrations. Previous studies indicated that SHBG from cirrhotic men selectively delivers estradiol, but not testosterone, to peripheral tissues of rats in vivo. These results suggest that estradiol and testosterone may bind to different SHBG isoforms in serum and that the estradiol-binding isoforms may be selectively altered in cirrhosis. This hypothesis was tested by polyacrylamide gel isoelectric focusing and fast protein liquid chromatography chromatofocusing. After Concanavalin-A affinity purification of serum glycoproteins from pregnant women, normal men, normal women, and cirrhotic men, the glycoprotein fraction was reconstituted, labeled with [3H]testosterone or [3H]estradiol, and applied to isoelectric focusing gels. Testosterone was bound selectively by the most acidic isoforms of SHBG, pI 4.5-5.4, and there was a significant anodal shift of the estradiol-binding isoforms in serum from cirrhotic men compared to that in serum from normal men. The selective binding of testosterone to the most acidic isoforms of SHBG was confirmed by fast protein liquid chromatography chromatofocusing, wherein the binding reactions were measured at neutral pH after separation of the isoforms. These biochemical studies and previous physiological experiments question the conventional view that testosterone and estradiol bind to a single competitive binding site on SHBG. Rather, testosterone is selectively bound by the most acidic SHBG isoforms. The estradiol-binding isoforms undergo a significant anodal shift in cirrhosis; this abnormality may result in the lack of decrease in estradiol MCR in cirrhosis.
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PMID:Differential binding of testosterone and estradiol to isoforms of sex hormone-binding globulin: selective alteration of estradiol binding in cirrhosis. 341 44

Serum concentrations of oestrone, oestradiol, follicle-stimulating hormone (FSH), luteinizing hormone (LH), and sex hormone-binding globulin (SHBG) were significantly (P less than 0.01) raised in men with alcoholic liver cirrhosis (no. = 42) compared with age-matched controls (no. = 20). No significant difference was observed when comparing serum testosterone concentrations. Patients were divided into three groups in accordance with the severity of liver cirrhosis, using biochemical and clinical criteria. Patients with the best-preserved liver function (no. = 11) and patients with moderately affected liver function (no. = 18) had significantly (P less than 0.05) raised serum concentrations of testosterone, FSH, and LH when compared with both controls and patients with severely affected liver function (no. = 13). Serum concentrations of testosterone, FSH, and LH in the latter group showed no significant differences from the controls. Serum concentrations of oestrone and oestradiol were significantly (P less than 0.05) increased in all patient groups, and serum oestrone increased with decreasing liver function. No significant differences were observed concerning SHBG concentrations in the three groups of patients. Dexamethasone suppression did not change the concentration of testosterone significantly, but oestrone and oestradiol concentrations decreased significantly (P less than 0.01) in controls and patients. In patients, but not in controls, a significant (P less than 0.01) increase in FSH and LH concentrations was observed after dexamethasone suppression. The mean percentage increase of FSH and LH was higher the greater the severity of liver cirrhosis.
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PMID:Hypothalamic-pituitary-gonadal function in relation to liver function in men with alcoholic cirrhosis. 642 16

The binding capacities of SHBG and CBG were measured by agar gel electrophoresis in 63 men with cirrhosis of the liver and in 42 healthy male subjects. The normal range (X- +/- 2s) for SHBG was 8.3-17.1 microgram/l, for CBG 46.4-82.8 micrograms/l. SHBG binding capacity was significantly higher in men with liver cirrhosis (mean 18;1 microgram/l; p less than 0.001) but CBG binding capacity was significantly lower (mean 49.7 microgram/l; p less than 0.001). Although SHBG was lower in patients with decreased CBG binding capacity, a correlation between both steroid binding proteins did not exist. Moreover, there was no correlation between SHBG or CBG on one hand and other parameters of hepatic protein synthesis such as serum protein concentration, cholinesterase activity and the coagulation factors V and VII on the other hand. In contrast to liver cirrhosis, 12 patients with fatty liver and 11 patients with toxic fibrosis of the liver did not reveal changes in SHBG or CBG. Treatment with spironolactone (200 mg daily for one week in 9 subjects) did not change the steroid binding capacity of human serum.
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PMID:[Binding capacity of sex hormone binding globulin and corticosteroid binding globulin in serum of male patients with liver cirrhosis (author's transl)]. 718 44

Metabolism of estradiol in men with cirrhosis and subjects with systemic lupus erythematosus results in an excessive formation of 16 alpha-hydroxyestrone. Examination of the biological activity of this metabolite showed that it is a potent uterotropic agent and that it exhibits minimal affinity for the human sex hormone-binding globulin. These biological characteristics are consistent with a hyperestrongenic response to the substance, which may be reflected in the pathology and etiology of these diseases.
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PMID:Biological properties of 16 alpha-hydroxyestrone: implications in estrogen physiology and pathophysiology. 719 Sep 77


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