Mechanism of hypogonadism in cirrhotic males.
Open Access
- 1 October 1977
- Vol. 18 (10), 843-853
- https://doi.org/10.1136/gut.18.10.843
Abstract
Men with chronic liver disease frequently develop clinical signs of hypogonadism and overt feminisation. Associated with these features, they have been found to have a reduced production of testosterone with low plasma concentrations, but only a minority of cirrhotic men would seem to have a marginal increase in circulating biologically potent oestrogens. Furthermore, this latter finding does not correlate with the presence of clinical feminisation. The original hypothesis to explain these changes now seems less likely to be true and no other single hypothesis has, on its own, been found to provide an adequate explanation for all the clinical and biochemical features found in cirrhotic men. It may be that the pathogenesis of endocrine changes in cirrhotic men is multifactorial--for instance, a combination of decreased hepatic clearance of some oestrogenic compounds, an autoimmune mediated primary testicular defect, and a specific potentiation effect by alcohol. Alternatively, it may be that none of these suggested mechanisms is of importance and that the endocrine changes are mediated instead by other mechanisms which remain, as yet, undiscovered or unconsidered. The fascination which this problem has held for clinicians and biochemists for many years seems likely to persist for some time to come.This publication has 65 references indexed in Scilit:
- Plasma oestrogens in men with chronic liver disease.Gut, 1976
- Hypothalamic-pituitary-gonadal function in men with cirrhosis of the liver.Gut, 1976
- HORMONAL STUDIES IN KLINEFELTER'S SYNDROMEClinical Endocrinology, 1975
- Simultaneous measurement of unbound testosterone and estradiol fractions in undiluted plasma at 37°C by steady-state gel filtrationSteroids, 1974
- BIOLOGICALLY ACTIVE ANDROGENS AND ŒSTRADIOL IN MEN WITH CHRONIC LIVER DISEASEThe Lancet, 1973
- STIMULATION TESTS OF PITUITARY-LEYDIG CELL FUNCTION IN NORMAL MALE SUBJECTS AND HYPOGONADAL MENClinical Endocrinology, 1972
- ADRENAL SECRETION OF ANDROGENS AND OESTROGENSJournal of Endocrinology, 1969
- Oestrogen metabolism and excretion in liver diseaseGut, 1964
- HORMONE EXCRETION IN LIVER DISEASE 1JCI Insight, 1952
- A NOTE ON THE DEVELOPMENT OF CUTANEOUS ARTERIAL “SPIDERS” AND PALMAR ERYTHEMA IN PERSONS WITH LIVER DISEASE AND THEIR DEVELOPMENT FOLLOWING THE ADMINISTRATION OF ESTROGENSThe American Journal of the Medical Sciences, 1942