Oral Testosterone Load Related to Liver Function in Men with Alcoholic Liver Cirrhosis

Abstract

The relation between liver function and an oral testosterone load was examined in 42 consecutive patients with alcoholic liver cirrhosis. Administration of an oral load of 400 mg micronized free testosterone increased the serum concentration of testosterone (range, 31.9-694.4 nmol/l; median, 140.8 nmol/l) in male patients with alcoholic liver cirrhosis to significantly (P < 0.01) higher levels than in male subjects without liver disease (range, 25.4-106.6 nmol/l; median, 61.5 nmol/l). The increase of testosterone after the load (log Δ testosterone) in patients correlated inversely with galactose elimination capacity (r = −0.54; P < 0.001), serum albumin (r = −0.53; P < 0.001), plasma factor II + VII + X (r = −0.62; P < 0.001), indocyanine green clearance (r = −0.71; P < 0.001), and hepatic blood flow (r = −0.61; P < 0.01) and correlated directly with wedged-to-free hepatic vein pressure (r = +0.54; P < 0.01). The increase of testosterone after the load did not correlate significantly with sex hormone-binding globulin (r = +0.35; P > 0.05). It is concluded that the hepatic extraction of testosterone is significantly decreased in patients with alcoholic cirrhosis. This decrease seems to be due to decreased liver function, decreasing hepatic blood flow, and increased portosystemic shunting. Oral testosterone loading may therefore be of prognostic significance in patients with alcoholic liver cirrhosis.