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

4 patients with breast cancer, treated with Calusterone, a 17-alkylated, orally active androgenic steroid, were studied to determine the effect of this drug on testosterone metabolism. Testosterone tracer doses were administered before and on the 15th-77th day of Calusterone therapy. Urine collection was made to examine the excretion of endogenous androgen metabolites. Total glucuronide metabolites of the tracer decreased significantly (55% to 43% of the dose). The androsterone/etiocholanolone ratio rose by a factor of 2-4 and there was increased formation of uncharacterized polar metabolites. Significant changes in the androsterone/etiocholanolone ratio in these patients was absent. The changes seen resemble those observed in cirrhosis of the liver. It is concluded that the effects of Calusterone on testosterone metabolism resemble the effects on cortisol or estradiol metabolism. These represent nonspecific effects on hepatic structure and function with unrelated therapeutic effect in breast cancer.
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PMID:The effect of 7beta, 17alpha-dimethyltestosterone (calusteron) on testosterone metabolism in women with advanced breast cancer. 14 59

The results of the controlled study covering 21 cases of decompensated hepatic cirrhosis are repoted. Nine controls received conventional therapy with diuretics and vitamin supplement. Testosteron 100 mg intramuscularly, on alternate days for four weeks, was administered to 12 others, in addition to the conventional therapy. Patients in the testosterone group responded with reduction in ascites and pedal edema together with a subjective feeling of improvement. Serum albumin rose at the end of the four weeks while globulin fell in those that received the hormone. The difference in respect of both serum albumin and globulin in the testosterone group became statistically significant at the end of four weeks.
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PMID:Testosterone in the management of cirrhosis of the liver--a controlled study. 35 Feb 13

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

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

A double-blind, placebo-controlled multicenter trial was conducted to determine the efficacy of oral testosterone treatment (200 mg three times daily) in men with alcoholic cirrhosis. By skewed randomization (3:2), 134 patients received testosterone and 87 placebo. Patients were followed from 8 to 62 months (median = 28 months). In the testosterone group, 33 patients died (25%; 95% confidence limits = 18 to 33%) as compared to 18 (21%; 95% confidence limits = 13 to 31%) in the placebo group. Taking age and significant prognostic variables into consideration, this corresponds with a relative mortality risk of 1.17 (95% confidence limits = 0.65 to 2.15) in the testosterone group vs. the placebo group. Testosterone treatment did not significantly affect liver biochemistry, prevalence of complications to cirrhosis or causes of death. Patients treated with testosterone developed significantly (p less than 0.05) higher serum testosterone and blood hemoglobin concentrations and significantly (p less than 0.05) lower plasma IgM concentrations as compared to the placebo group. The prevalence of gynecomastia decreased significantly (p less than 0.05) in the testosterone group as compared to the placebo group. We conclude that oral testosterone treatment has no beneficial effect on survival and liver biochemistry in men with alcoholic cirrhosis, and adverse effects cannot be excluded.
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PMID:Testosterone treatment of men with alcoholic cirrhosis: a double-blind study. The Copenhagen Study Group for Liver Diseases. 287 27

The effect of oral testosterone treatment (200 mg tid) on liver morphology was examined in a double-blind, placebo controlled study including men with alcoholic cirrhosis (n = 126). Liver biopsies obtained before randomization showed micronodular cirrhosis in 119 patients (94%), alcoholic hepatitis in 64 (51%), and fatty liver in 104 (83%). These and other morphological findings did not differ significantly in the patients randomized to testosterone (n = 76) and to placebo (n = 50) (skewed randomization 3:2). Follow-up liver specimens (biopsies or autopsies) obtained after a median treatment duration of 30 months demonstrated a significant (p less than 0.01) increase in the prevalence of macronodular cirrhosis (from 6 to 51%) and a significant (p less than 0.01) decrease in the prevalence of alcoholic hepatitis (to 21%) and of fatty liver (to 52%). Testosterone treatment did not significantly influence the prevalence of these changes. Further, testosterone treatment had no significant effect on the prevalence of other morphological changes, including vascular and malignant changes. However, in the testosterone-treated group one patient developed diffuse sinusoidal dilation and one patient showed Budd-Chiari's syndrome. The degree of fatty liver and of alcoholic hepatitis in follow-up liver specimens were significantly (p less than 0.002) higher among patients who consumed ethanol during follow-up than in patients who abstained (76 versus 22% and 30 versus 6%). In conclusion, this study does not establish any indication or any contraindication in terms of hepatic histopathology with the possible exception of hepatic venous thrombosis for the use of oral testosterone treatment in men with alcoholic cirrhosis.
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PMID:No effect of long-term oral testosterone treatment on liver morphology in men with alcoholic cirrhosis. 330 Feb 74

This study was performed to ascertain whether testosterone metabolism is altered in male rats with portal bypass, and whether such changes could contribute to the reduction in serum testosterone concentration and raised serum estrogen levels that are observed in this situation. The metabolic clearance rate of testosterone was determined by a prime-dose constant-infusion technique in male rats subjected to complete portal vein ligation and in sham-operated controls. Testosterone clearance was similar in rats with portal vein ligation and control rats (9.01 +/- 2.29 and 8.26 +/- 2.83 ml/min, respectively) but the clearance per gram of liver was greater in rats with portal vein ligation than in controls (1.18 +/- 0.18 versus 0.68 +/- 0.24 ml/min.g liver, p less than 0.0001). After 180 min of [3H]testosterone infusion, [3H]estradiol comprised 1.2% of plasma total radioactivity in male controls but was increased to 11% in rats with portal vein ligation (p less than 0.005). Similarly, biliary excretion of [3H]estradiol was eightfold greater in male rats with portal vein ligation compared with controls (p less than 0.001). In control male rats, the major metabolites of testosterone present in bile were 2 alpha-hydroxytestosterone, 16 alpha-hydroxytestosterone, and 7 alpha-hydroxytestosterone. Portal bypass was associated with reduced biliary excretion of 2 alpha-hydroxytestosterone and 16 alpha-hydroxytestosterone to approximately 50% of control, but there was no change in the excretion of 7 alpha-hydroxytestosterone. Conversely, portal bypass was associated with increased formation of dihydrotestosterone, indicating stimulated activity of testosterone 5 alpha-reductase. It is concluded that portal bypass in male rats is associated with altered pathways of testosterone metabolism and, in particular, with increased aromatization of testosterone to estradiol. The site of such estradiol formation has not been determined by this in vivo study. However, selective changes occurred in the regiospecific and stereospecific hydroxylation pathways of testosterone and in 5 alpha-reductase activity after portal bypass in male rats. It is concluded that portal bypass, in the absence of parenchymal liver damage, results in demasculinization and feminization of C19 steroid metabolism in the male rat liver. These metabolic changes could be revelant to the pathogenesis of changes in sexual characteristics in cirrhosis.
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PMID:Hepatic testosterone metabolism in male rats with portal bypass. 339 70

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

Anterior pituitary functions and sex steroid levels were measured in 12 patients with idiopathic haemochromatosis (eight males, four postmenopausal females) and age-matched controls, 12 with diabetes mellitus and five with hepatic cirrhosis. In idiopathic haemochromatosis gonadotrophin deficiency was present in seven of 12 patients including six of seven patients who had clinical evidence of hypogonadism. Basal prolactin levels were significantly lower in the patients with idiopathic haemochromatosis compared with either of the control groups (p less than 0.02). Nine patients with idiopathic haemochromatosis exhibited subnormal prolactin responses to thyrotrophin releasing hormone. Thyroid and adrenocortical functions were normal in all patients with idiopathic haemochromatosis. Testosterone values were subnormal in five of eight males with idiopathic haemochromatosis; females with idiopathic haemochromatosis had significantly lower testosterone values compared with the diabetic females (p less than 0.05). Oestradiol values in both sexes and sex hormone binding globulin values in the males were not significantly different in patients with idiopathic haemochromatosis compared with the controls. Sex hormone binding globulin levels were significantly higher in females with idiopathic haemochromatosis compared with either diabetic or cirrhotic females (p less than 0.05). Impairment of anterior pituitary function occurs in idiopathic haemochromatosis but is selective; gonadotrophin and prolactin deficiencies are common. Clinical hypogonadism is usually hypogonadotrophic in origin.
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PMID:Endocrine abnormalities in idiopathic haemochromatosis. 668 54


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