Kumar K V S Hari, Pawah A K, Manrai Manish
Department of Endocrinology, Command Hospital, Chandimandir, Panchkula, Haryana, India.
Department of Medicine, Mayo Institute of Medical Sciences, Barabanki, Uttar Pradesh, India.
J Family Med Prim Care. 2016 Jul-Sep;5(3):576-580. doi: 10.4103/2249-4863.197293.
Liver dysfunction leads to endocrine disturbance due to the alteration in protein metabolism or synthesis. We studied the presence of occult endocrine dysfunction in liver cirrhosis and compared the same with underlying etiology.
We evaluated thirty patients with liver cirrhosis in this cross-sectional, observational study. All subjects were assessed for pituitary, thyroid, adrenal, and gonadal function. The patients were divided into Group 1 (cirrhosis, = 30) and Group 2 (controls, = 15) and the data were analyzed with appropriate statistical tests.
The study participants (20 males, 10 females) had a mean age of 54.5 ± 12.4 years and duration of the cirrhosis 5.1 ± 2.7 years. Four patients were in Child Class A, 11 and 15 patients were in Child Classes B and C, respectively. Eleven out of thirty patients (37%) had endocrine disorders, that include subclinical hypothyroidism ( = 3), primary hypothyroidism ( = 1), Sick Euthyroid syndrome ( = 3), central hypothyroidism ( = 2), secondary hypogonadism ( = 3) and growth hormone deficiency in three patients. Two patients had partial hypopituitarism and one patient had complete hypopituitarism.
Occult endocrine dysfunction of thyroid and gonadal axes is common in patients with cirrhosis of the liver. The hormonal abnormalities are not different based on the etiology of the cirrhosis.
肝功能障碍会因蛋白质代谢或合成的改变而导致内分泌紊乱。我们研究了肝硬化患者隐匿性内分泌功能障碍的存在情况，并将其与潜在病因进行了比较。
在这项横断面观察性研究中，我们评估了30例肝硬化患者。对所有受试者的垂体、甲状腺、肾上腺和性腺功能进行了评估。将患者分为第1组（肝硬化组，n = 30）和第2组（对照组，n = 15），并使用适当的统计检验对数据进行分析。
研究参与者（20名男性，10名女性）的平均年龄为54.5±12.4岁，肝硬化病程为5.1±2.7年。4例患者为Child A级，11例和15例患者分别为Child B级和C级。30例患者中有11例（37%）存在内分泌紊乱，包括亚临床甲状腺功能减退（n = 3）、原发性甲状腺功能减退（n = 1）、正常甲状腺病态综合征（n = 3）、中枢性甲状腺功能减退（n = 2）、继发性性腺功能减退（n = 3）以及3例患者生长激素缺乏。2例患者存在部分垂体功能减退，1例患者存在完全垂体功能减退。
肝硬化患者中甲状腺和性腺轴的隐匿性内分泌功能障碍很常见。基于肝硬化的病因，激素异常情况并无差异。
