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Hypogonadism is not related to the etiology of liver cirrhosis

  • Liver, Pancreas, and Biliary Tract
  • Published:
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Abstract

We investigated the clinical and laboratory findings of hypogonadism and feminization in male patients with viral or alcoholic cirrhosis to determine whether chronic liver disease plays a primary role in the development of sexual dysfunction and hormonal changes. Two groups of male patients with liver cirrhosis (23 alcoholic, 33 viral) age-and Child's gradematched, and 20 age-matched healthy men, as a control group, were included in this study. Clinical signs of hypogonadism and feminization were examined in the cirrhotic patients. Follicle-stimulating hormone, luteinizing hormone, prolactin, testosterone, free testosterone, estradiol, androstenedione, dehydroepiandrosterone sulfate, and sex hormone-binding globulin were estimated in all groups. Seminal fluid was also analyzed in 7 alcoholic and 15 viral cirrhotics. Serum levels of estradiol, androstenedione, and sex hormone-binding globulin were significantly higher, and free testosterone and dehydroepiandrosterone sulfate levels were significantly lower in both groups of cirrhotics compared with the control group. Child's C patients in both groups of cirrhotics were found to have higher estradiol and lower free testosterone levels than child's A and B patients. Alcoholic and viral cirrhotics had markedly reduced sperm motility and density. The differences between alcoholic and viral cirrhotic patients in the clinical signs of hypogonadism, serum levels of sex steroids, and the results of seminal fluid analysis were not statistically significant. These findings suggest that liver cirrhosis per se, independent of etiology, causes hypogonadism and feminization, and that the degree of hypogonadism and feminization correlates well with the severity of liver failure.

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References

  1. Green JRB. Mechanism of hypogonadism in cirrhotic males. Gut 1977;18:843–853.

    CAS  PubMed  Google Scholar 

  2. Bannister P, Losowsky MS. Sex hormones and chronic liver disease. J Hepatol 1988;6:258–262.

    Article  CAS  PubMed  Google Scholar 

  3. Jensen SB, Gluud C, and Copenhagen Study Group for Liver Diseases. Sexual dysfunction in men with alcoholic liver cirrhosis: A comparative study. Liver 1985;5:94–100.

    CAS  PubMed  Google Scholar 

  4. Galvao-Teles A, Goncalves L, Vieira MR, et al. Male hypogonadism in alcoholic patients with and without liver cirrhosis. In: Langer, M, Chiandussi L, Chopra IJ, Martini L (eds) The endocrines and the liver. Serona symposia. Vol 51. London: Academic, 1982;135–144.

    Google Scholar 

  5. Van Thiel DH, Gavaler JS, Spero JA, et al. Patterns of hypothalamic-pituitary-gonadal dysfunction in men with liver disease due to differing etiologies. Hepatology 1981;1:39–46.

    PubMed  Google Scholar 

  6. Bannister P, Oates J, Sheridan P, Losowsky MS. Sex hormone changes in chronic liver disease: A matched study of alcoholic versus nonalcoholic liver disease. Q J Med 1987;63:305–313.

    CAS  PubMed  Google Scholar 

  7. Wang YJ, Wu JC, Lee SD, et al. Gonadal dysfunction and changes in sex hormones in postnecrotic cirrhotic men: A matched study with alcoholic men. Hepatogastroenterology 1991;38:531–534.

    CAS  PubMed  Google Scholar 

  8. Baptista A, and Members of International Study Group for Alcoholic Liver Disease. Alcoholic liver disease: Morphological manifestations. Lancet 1981;I:707–711.

    Google Scholar 

  9. Child CG, Turcotte JG: Surgery and portal hypertension. In: Child CG (ed) The liver and portal hypertension. Philadelphia: WB Saunders, 1964;1–85.

    Google Scholar 

  10. Niewoehner CB, Nutall FQ. Gynecomastia in a hospitalized male population. Am J Med 1984;77:633–638.

    Article  CAS  PubMed  Google Scholar 

  11. Galvao-Teles A, Monteiro E, Gavaler JS, Van Thiel DH. Gonadal consequences of alcohol abuse. Lessons from the liver. Hepatology 1986;6:135–140.

    CAS  PubMed  Google Scholar 

  12. Gavaler JS, Van Thiel DH. Gonadal dysfunction and inadequate sexual performance in alcoholic cirrhotic men. Gastroenterology 1988;95:1680–1683.

    CAS  PubMed  Google Scholar 

  13. Kley HK, Nieschlag E, Wiegelman W, et al. Steroid hormones and their binding in plasma of male patients with fatty liver, chronic hepatitis and liver cirrhosis. Acta Endocrinol (Copenhg) 1975;79:275–285.

    CAS  Google Scholar 

  14. Olivo J, Gordon GG, Rafii F, Southren AL. Estrogen metabolism in hyperthyroidism and cirrhosis of the liver. Steroids 1975; 26:47–56.

    Article  CAS  PubMed  Google Scholar 

  15. Chopra IJ, Tulchinsky D, Greenway FL. Estrogen-androgen imbalance in hepatic cirrhosis. Ann Intern Med 1973;79:198–203.

    CAS  PubMed  Google Scholar 

  16. Galvao-Teles A, Anderson DC, Burke GW, et al. Biologically active androgens and oestradiol in men with chronic liver disease. Lancet 1973;1:173–177.

    CAS  PubMed  Google Scholar 

  17. Van Thiel DH, Gavaler JS, Slone FL, et al. Is feminization in alcoholic men due in part to portal hypertensions? A rat model. Gastroenterology 1980;78:81–91.

    PubMed  Google Scholar 

  18. Zifroni A, Schiavi RC, Schaffner F. Sexual function and testosterone levels in men with nonalcoholic liver disease. Hepatology 1991;14:479–482.

    CAS  PubMed  Google Scholar 

  19. Van Thiel DH, Lester R, sherins RJ. Hypogonadism in alcoholic liver disease: Evidence for a double defect. Gastroenterology 1974;67:1188–1199.

    PubMed  Google Scholar 

  20. Valimaki M, Salaspuro M, Harkönen M, et al. Liver damage and sex hormones in chronic male alcoholics. Clin Endocrinol 1982;17:469–477.

    CAS  Google Scholar 

  21. Kent JR, Scaramuzzi RJ, Lauwers W, et al. Plasma testosterone, estradiol and gonadotrophins in hepatic insufficiency. Gastroenterology 1973;64:111–115.

    CAS  PubMed  Google Scholar 

  22. Maruyama Y, Adachi Y, Aoki N, et al. Mechanism of feminization in male patients with non-alcoholic liver cirrhosis: Role of sex hormone-binding globulin. Gastroenterol Jpn 1991;26:435–439.

    CAS  PubMed  Google Scholar 

  23. Cornely CM, Schade RR, Van Thiel DH, Gavaler JS. Chronic advanced liver disease and impotence: Cause and effect? Hepatology 1984;4:1227–1230.

    CAS  PubMed  Google Scholar 

  24. Mowat NAG, Edwards CRW, Fisher R, et al. Hypothalamicpituitary-gonadal function in men with cirrhosis of the liver. Gut 1976;17:345–350.

    CAS  PubMed  Google Scholar 

  25. Bannister P, Handley T, Chapman C, Losowsky MS. Hypogonadism in chronic liver disease: Impaired release of luteinising hormone. BMJ 1986;293:1191–1193.

    CAS  PubMed  Google Scholar 

  26. Van Thiel DH, Gavaler JS, Cobb CF, et al. Alcohol-induced testicular atrophy in the adult male rat. Endocrinology 1979; 105:888–895.

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Gastroenterohepatology Istanbul University, Istanbul Medical Faculty, Çapa, 34390, Istanbul, Turkey

    Sabahattin Kaymakoĝlu, Atilla Ökten, Yilmaz Çakaloĝlu, Güngör Boztaş, Fatih Beşişik & Süleyman Yalçin

  2. Division of Internal Medicine, Istanbul University, Istanbul Medical Faculty, Çapa, 34390, Istanbul, Turkey

    Cemil Taşçioĝlu

Authors
  1. Sabahattin Kaymakoĝlu
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  2. Atilla Ökten
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  3. Yilmaz Çakaloĝlu
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  4. Güngör Boztaş
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  5. Fatih Beşişik
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  6. Cemil Taşçioĝlu
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  7. Süleyman Yalçin
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Kaymakoĝlu, S., Ökten, A., Çakaloĝlu, Y. et al. Hypogonadism is not related to the etiology of liver cirrhosis. J Gastroenterol 30, 745–750 (1995). https://doi.org/10.1007/BF02349641

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  • DOI: https://doi.org/10.1007/BF02349641

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