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)

Thirty men with chronic alcoholism were studied. Biopsies of the liver and testis were performed in all. Serum concentrations of total and non-protein bound (free) testosterone and oestradiol, dihydrotestosterone and sex-hormone binding globulin (SHBG) were determined. Testosterone and dihydrotestosterone concentrations were normal in most patients, whereas oestradiol and free oestradiol were above normal in approximately 50% of the patients. None of the hormones measured differed significantly between patients with and without cirrhosis. SGBG was significantly higher in men with severely reduced spermatogenesis compared to those with intact germinal epithelium, but there was no difference between men with and without cirrhosis. No relation could be demonstrated between clinical signs of hypogonadism and any of the hormones measured. The results support the view that hormonal and sexual disturbances may occur in chronic alcoholism independent of the presence of liver disease.
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PMID:Sex steroids and sex-hormone binding globulin in males with chronic alcoholism. 10 17

A review of the factors historically thought to contribute to the feminization of men with Laennec's cirrhosis is presented. Objective scientific data is presented both in support of and in rejection of such factors when available. Recent hypotheses about the significance of an altered estrogen to androgen (E/T) ratio as being important in the pathogenesis of feminization also are discussed. Finally, a hypothesis which incorporates the findings of hypogonadism and cirrhosis with portal-systemic shunting is presented as a pathogenic mechanism for the feminization of men with alcohol-induced Laennec's cirrhosis.
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PMID:Feminization of chronic alcoholic men: a formulation. 45 31

Blood levels of estradiol, testosterone, luteinizing hormone (LH), follicle stimulating hormone (FSH), sex steroid binding globulin (SSBG), and free steroids were surveyed in 117 men to define the pattern of hormonal abnormalities and to examine the relationships between the hormone levels and the development of the endocrine features of cirrhosis. When compared with healthy men of similar ages, the patients had significantly lower metabolic clearance rates (p .001), testosterone production rates (p .001), total and free levels of testosterone (p .001), reduced testosterone responses to human chorionic gonadotropin (HCG) stimulation, higher estradiol, LH, and FSH levels, and higher binding capacities of SSBG. The metabolic clearance and plasma production rates of estradiol were not markedly different from those of controls. Severely ill patients with liver failure of hemochromatosis had low levels of LH and FSH respones to clomiphene and LH-releasing hormone. Patients with gynecomastia and spider naevi had higher estradiol levels than in those without these signs. Longitudinal studies indicated that the hormonal levels, endocrine features, and severity of the liver disease could change independently. It is concluded that the clearance of estradiol from plasma is normal in most patients with liver disease and that reduced degradation of estrogens is not the initial event in the sequence leading to the hormonal abnormalities of cirrhosis. Usual findings of liver failure are elevated gonadotropin levels and a poor Leydig cell response to HCG which suggest that the hypogonadism is primary in most patients with cirrhosis. Discrepancies in the expected relationships between the hormone and clinical changes suggest that other factors than those studied are also involved in the genesis of hepatic cirrhosis.
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PMID:A study of the endocrine manifestations of hepatic cirrhosis. 76 39

Literature on the role of estrogens in men is reviewed. The primary active estrogens in males and females are estradiol-17beta (E2), estrone (E1), and estriol (E3). The active constituents of serum E2 and testosterone (T) are those which are not bound by testosterone-estrogen binding globulin (TEBG). The concentration of TEBG is stimulated by estrogen and suppressed by androgens. Both E1 and E2 appear to be derived from the peripheral metabolism of T and androstenedione. The metabolism and physiological roles of estrogens in men are briefly discussed. The association of gynecomastia with puberty, cirrhosis of the liver, hyperthyroidism, chronic renal failure, refeeding gynecomastia, administration of digitalis and diuretics, neoplasms, and hypergonadotropic hypogonadism is reviewed. In older men, the ratio of free E2:T is increased. The relationship of andorgens, estrogens, and male sex behavior is briefly reviewed. Areas for future research include the mechanisms by which estrogens and androgens exert antagonistic effects on similar tissues, variations in the fractional conversionr ate of androgens to estrogens, the etiology of pubertal gynecomastia, the role of the free E2:T ratio in male social and sexual behavior, and the interrelation between behavior, nutrition, hormone secretion, and degenerative changes such as benign prostatic hyperplasia.
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PMID:Estrogens and the human male. 77 4

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.
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PMID:Steroid hormones and their binding in plasma of male patients with fatty liver, chronic hepatitis and liver cirrhosis. 117 87

A chronic etylist 46 year old female patient with a chronic active hepatitis of a probable alcoholic origin in presented. Between 1983 an 1987 she became pregnant three times and had normal children. We suggest probable hypotheses for etiology of hepatic cirrhosis, hypogonadism and sterility.
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PMID:[Liver cirrhosis and pregnancy. An infrequent association. A rare case of liver cirrhosis with 3 pregnancies]. 134 Jun 77

With the aim of evaluating the glucocorticoid function and the role of the adrenal gland in hypogonadism and feminization of cirrhotic patients, we examined 11 patients with virus-induced liver cirrhosis and 8 normal subjects as controls. In each subject serum levels of cortisol (C), progesterone (P), dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulphate (DHEAS), delta 4-androstenedione (A), estrone (E1), testosterone (T), luteinizing hormone (LH) were assayed in basal conditions and after adrenocorticotropic hormone (ACTH) stimulation. Serum levels of ACTH, C, E1, estradiol (E2), T were assayed in basal condition and after dexamethasone suppression test. Moreover, a circadian study of ACTH, C and corticosteroid-binding globulin (CBG) was performed, with blood samples drawn at 8:00 and 20:00 on two consecutive days. Our results demonstrate that in cirrhosis: 1) normal levels of C, when metabolism is altered and CBG levels are reduced, are maintained by inhibition of ACTH secretion; 2) circadian rhythmicity of the pituitary-adrenal axis is well preserved; 3) in non-alcoholic cirrhosis, too, there is a reduction of androgens (T, DHEA, DHEAS, A) and a rise of estrogens (E2 and, more markedly, E1) and P; 4) in cirrhotic men E1 is mainly of adrenal origin and contributes, through negative feedback on LH secretion, to low levels of T.
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PMID:[Hypothalamo-pituitary-adrenal function in liver cirrhosis of viral etiology]. 174 24

Hereditary haemochromatosis is an autosomal recessive disease that is genetically expressed by excessive accumulation of iron in the tissues, resulting in cirrhosis, diabetes mellitus, cardiomyopathy and hypogonadism. As the disease may be diagnosed before the appearance of symptoms, and prevented by repeated phlebotomies, there are strong implications for adoption of a screening procedure. Determinations of transferrin saturation (TS) and serum ferritin concentration (SF) were used to screen 4302 blood donors, who were selected for follow-up studies if they fulfilled any of the following three criteria: (i) TS greater than or equal to 0.7; (ii) TS greater than or equal to 0.5 together with SF greater than or equal to 150 micrograms l-1; (iii) SF greater than or equal to 300 micrograms l-1. A total of 58 subjects who fulfilled at least one of these criteria were reinvestigated, after which 18 individuals still fulfilled at least one criterion. Fifteen subjects having SF greater than or equal to 300 micrograms l-1 were offered liver biopsy and thirteen of these accepted. In one individual, no stainable iron was detected, and two subjects did not fulfil the previously established diagnostic criteria for the diagnosis of hereditary haemochromatosis. Ten subjects who had a high TS and liver iron grade 2-4 according to Bassett were classified accordingly as homozygotes. On the basis of these results, the prevalence of haemochromatosis in Denmark was estimated to be 0.0037-0.0046.
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PMID:Screening for haemochromatosis: prevalence among Danish blood donors. 189 49

The clinical signs and symptoms of sexual dysfunction with amenorrhoea, loss of libido and infertility, are frequently found in chronic alcoholic women. But few investigations have been made concerning hormonal changes in fertile aged women experiencing sexual dysfunction. In order to assess prolactin levels of fertile-aged women with alcoholism under 40 years of age-excluding those with liver cirrhosis were surveyed. We found that many of them (82.6%) had moderate elevations of plasma prolactin. Hyperprolactinemia is commonly associated with amenorrhoea and hypogonadism. An acute alcohol loading experiment was conducted on 6 healthy female volunteers in luteal phases of their menstrual cycles in order to evaluate the effects of alcohol on the hypothalamo-pituitary-ovarian axis. Evidence was obtained that alcohol intake caused transient hyperprolactinemia. The present results indicated that hyperprolactinemia can occur with high frequency among alcoholic women and this causes sexual dysfunction and ovarian dysfunction. The etiology of hyperprolactinemia could not be explained solely by the direct action of alcohol, rather, liver dysfunction must be implicated.
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PMID:[A study on hyperprolactinemia in female patients with alcoholics]. 206 37

Sex hormone binding globulin (SHBG) is a glycoprotein possessing high affinity binding for 17 beta-hydroxysteriod hormones such as testosterone and oestradiol. It is probably synthesized in the liver, plasma concentrations being regulated by, amongst other things, androgen/oestrogen balance, thyroid hormones, insulin and dietary factors, it is involved in transport of sex steroids in plasma and its concentration is a major factor regulating their distribution between the protein-bound and free states. Its detailed role in the delivery of hormones to target tissues is not yet clear. Plasma SHBG concentrations are affected by a number of different diseases, high values being found in hyperthyroidism, hypogonadism, androgen insensitivity and hepatic cirrhosis in men. Low concentrations are found in myxoedema, hyperprolactinaemia and syndromes of excessive androgen activity. Concentrations are also affected by drugs such as androgens, oestrogens, thyroid hormones and anti-convulsants. Measurement of SHBG is useful in the evaluation of mild disorders of androgen metabolism and enables identification of those women with hirsutism who are more likely to respond to oestrogen therapy. Testosterone:SHBG ratios correlate well with both measured and calculated values of free testosterone and help to discriminate subjects with excessive androgen activity from normal individuals.
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PMID:Sex hormone binding globulin: origin, function and clinical significance. 208 Aug 56


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