Systematic review: endocrine abnormalities in patients with liver cirrhosis

Abstract

Background: Cirrhosis is the end stage of many different forms of acute and chronic liver damages. Interactions between liver and endocrine system is significant, because liver is the main organ of metabolism and catabolism of many proteins.

Aim: In this study, current literature about endocrine abnormalities among patients with liver cirrhosis was reviewed.

Methods: A PubMed search was performed on English literature from January 1990 onward to find human studies reporting endocrine dysfunction in liver cirrhosis. Relevant articles were included and reviewed by two expert reviewers. Data were summarized ant tabulated in separate categories for each endocrine involvement.

Results: Among 944 studies, 36 articles were eligible for review. Growth hormone resistance and low Insulin like growth factor-1 are prevalent in patients with liver cirrhosis with negative impact on prognosis. Thyroid dysfunction is mostly seen in the form of sick euthyroid syndrome. Osteoporosis is also prevalent in cirrhosis but the exact mechanism is not clear. Adrenal insufficiency is a prevalent clinical feature both in compensated and critically ill patients with cirrhosis with negative impact on patients' outcomes.

Conclusion: Disorders of endocrine system is prevalent in cirrhosis. These patients should be checked and treated for these disorders to achieve a stable clinical situation and prepare for liver transplantation.