Dysfunction of the hypothalamic-pituitary-glandular axes and relation to Child-Pugh classification in male patients with alcoholic and virus-related cirrhosis
- PMID: 12702906
- DOI: 10.1097/01.meg.0000059115.41030.e0
Dysfunction of the hypothalamic-pituitary-glandular axes and relation to Child-Pugh classification in male patients with alcoholic and virus-related cirrhosis
Abstract
Objective: To investigate anterior pituitary function (adrenal, somatotropic, thyroid and gonadal axes, and prolactin) in relation to the Child-Pugh score in male patients with alcoholic and virus-related liver cirrhosis.
Method: Anterior pituitary function was evaluated in 52 male cirrhotics (26 Child-Pugh class A (CPA), 16 Child-Pugh class B (CPB) and 10 Child-Pugh class C (CPC)) by a combined pituitary stimulation test, and was compared with 50 age-matched controls.
Results: A normal cortisol response to corticotropin-releasing hormone (CRH) stimulation was demonstrated in 57.6% of CPA patients, 31.1% of CPB patients and 20% of CPC patients, while basal levels of adrenocorticotropic hormone (ACTH) and cortisol in cirrhotics were comparable to those in controls. Levels of basal growth hormone (P < 0.001) and stimulated growth hormone (P < 0.01) were significantly higher in cirrhotics compared with controls, while levels of insulin-like growth factor 1 (IGF-1) were significantly lower (P < 0.001). Basal prolactin levels were elevated significantly in CPC patients (P < 0.01), while stimulated prolactin as well as basal and stimulated thyroid-stimulating hormone (TSH) levels were comparable. Basal luteinizing hormone levels were significantly higher in CPA (P < 0.001) and CPB (P < 0.001) patients, and stimulated luteinizing hormone levels were significantly lower in CPC patients than in controls (P < 0.005). Basal and stimulated follicle-stimulating hormone (FSH) levels were comparable in all groups. Child-Pugh score was correlated positively to prolactin and was correlated negatively to IGF-1, stimulated luteinizing hormone and free testosterone.
Conclusions: In cirrhotics, the hypothalamic-pituitary-adrenal and -gonadal axes and prolactin secretion are impaired. Growth hormone response to growth hormone-releasing hormone (GHRH) is accelerated in cirrhotics. Thus, elevated basal and stimulated levels of growth hormone probably reflect compensation for low levels of IGF-1, which are associated with deteriorating liver function. The aetiology of cirrhosis was found to have no influence on the degree of alteration of the hypothalamic-pituitary-glandular axes.
Similar articles
-
Low serum dehydroepiandrosterone sulfate in women with primary Sjögren's syndrome as an isolated sign of impaired HPA axis function.J Rheumatol. 2001 Jun;28(6):1259-65. J Rheumatol. 2001. PMID: 11409117
-
Gonadal dysfunction and changes in sex hormones in postnecrotic cirrhotic men: a matched study with alcoholic cirrhotic men.Hepatogastroenterology. 1991 Dec;38(6):531-4. Hepatogastroenterology. 1991. PMID: 1778585
-
Uncoupling of sympathetic nervous system and hypothalamic-pituitary-adrenal axis in cirrhosis.J Gastroenterol Hepatol. 2008 Dec;23(12):1901-8. doi: 10.1111/j.1440-1746.2008.05456.x. Epub 2008 Jun 12. J Gastroenterol Hepatol. 2008. PMID: 18554237
-
Hypothalamic-pituitary function (LH, FSH and prolactin) in males with chronic liver diseases.Z Gastroenterol. 1979 Jul;17(7):422-38. Z Gastroenterol. 1979. PMID: 382660 Review.
-
Neuroendocrine and hormonal perturbations and relations to the serotonergic system in fibromyalgia patients.Scand J Rheumatol Suppl. 2000;113:8-12. Scand J Rheumatol Suppl. 2000. PMID: 11028824 Review.
Cited by
-
Hypothalamic Dysfunction and Multiple Sclerosis: Implications for Fatigue and Weight Dysregulation.Curr Neurol Neurosci Rep. 2016 Nov;16(11):98. doi: 10.1007/s11910-016-0700-3. Curr Neurol Neurosci Rep. 2016. PMID: 27662896 Free PMC article. Review.
-
Assessing men with erectile dysfunction before and after living donor liver transplantation in real-world practice: Integrating laboratories into clinical settings.PLoS One. 2018 Nov 20;13(11):e0206438. doi: 10.1371/journal.pone.0206438. eCollection 2018. PLoS One. 2018. PMID: 30458009 Free PMC article. Clinical Trial.
-
ASSESSMENT OF ADRENOCORTICAL DYSFUNCTION IN PATIENTS WITH STABLE LIVER CIRRHOSIS.Acta Endocrinol (Buchar). 2016 Jul-Sep;12(3):262-267. doi: 10.4183/aeb.2016.262. Acta Endocrinol (Buchar). 2016. PMID: 31149099 Free PMC article.
-
Pituitary protein 7B2 plasma levels in patients with liver disease: Comparisons with other hormones and neuropeptides.Oncol Lett. 2013 Aug;6(2):499-506. doi: 10.3892/ol.2013.1384. Epub 2013 Jun 7. Oncol Lett. 2013. PMID: 24137355 Free PMC article.
-
Testosterone deficiency in male organ transplant recipients.Int J Impot Res. 2022 Nov;34(7):679-684. doi: 10.1038/s41443-021-00513-9. Epub 2022 Jan 11. Int J Impot Res. 2022. PMID: 35013565 Review.
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical
Miscellaneous