De Besi L, Zucchetta P, Zotti S, Mastrogiacomo I
Institute of Semeiotica Medica, University of Padova, Italy.
Acta Endocrinol (Copenh). 1989 Mar;120(3):271-6. doi: 10.1530/acta.0.1200271.
The present work investigates the sex hormone profiles in 50 male patients with liver cirrhosis of different etiology according to the degree of liver dysfunction. The only hormonal impairment in well-compensated cirrhotics (group A) was an increase in mean serum concentrations of estrone, androstenedione, and sex hormone binding globulin. In decompensated cirrhotic patients with ascites (group B), low mean levels of total and free testosterone were found along with normal gonadotropins mean levels. Estrone and androstenedione levels were still elevated, whereas sex hormone binding globulin levels were not different from controls. In decompensated cirrhotics patients with encephalopathy (group C), total and free testosterone mean levels were lower than in group B, and LH mean levels were elevated; estrone levels were markedly high, but androstenedione levels were subnormal; sex hormone binding globulin concentrations were again not different from controls. The few patients with high prolactin levels belonged primarily to this group. Estradiol mean levels were not significantly elevated in any of the groups. It is concluded that the various hormonal patterns of gonadal failure and of the impairment of steroid metabolism and transport, observed in cirrhosis, can be attributed to the degree of liver dysfunction.
本研究根据肝功能障碍程度，对50例不同病因的男性肝硬化患者的性激素谱进行了调查。在代偿良好的肝硬化患者（A组）中，唯一的激素损害是雌酮、雄烯二酮和性激素结合球蛋白的平均血清浓度升高。在失代偿性肝硬化腹水患者（B组）中，发现总睾酮和游离睾酮的平均水平较低，而促性腺激素的平均水平正常。雌酮和雄烯二酮水平仍然升高，而性激素结合球蛋白水平与对照组无差异。在失代偿性肝硬化合并肝性脑病的患者（C组）中，总睾酮和游离睾酮的平均水平低于B组，促黄体生成素（LH）的平均水平升高；雌酮水平明显升高，但雄烯二酮水平低于正常；性激素结合球蛋白浓度再次与对照组无差异。少数催乳素水平高的患者主要属于该组。在任何一组中，雌二醇的平均水平均未显著升高。结论是，肝硬化中观察到的性腺功能衰竭以及类固醇代谢和转运受损的各种激素模式，可归因于肝功能障碍的程度。
