Vargas-Beltran Andres M, Armendariz-Pineda Samantha M, Martínez-Sánchez Froylan D, Martinez-Perez Carolina, Torre Aldo, Cordova-Gallardo Jacqueline
Department of Hepatology, General Hospital Dr. Manuel Gea Gonzalez, Mexico City 14080, Mexico.
Faculty of Medicine, Meritorious Autonomous University of Puebla, Puebla 72420, Mexico.
World J Gastroenterol. 2025 Aug 28;31(32):108827. doi: 10.3748/wjg.v31.i32.108827.
Endocrine disorders frequently lead to metabolic disturbances that significantly affect liver function. Understanding the complex interplay between hormonal imbalances and liver dysfunction is essential for advancing targeted therapeutic strategies. This comprehensive review explores the pathophysiological mechanisms linking major endocrine disorders to liver disease, with a focus on the roles of the thyroid, parathyroid, pancreas, adrenal glands, and sex hormones. Thyroid dysfunction is associated with alterations in liver enzyme levels and metabolic regulation, often resulting in hepatic steatosis or cholestasis. Hyperparathyroidism and consequent hypercalcemia have been linked to hepatic calcifications. Insulin resistance, both hepatic and peripheral, contributes to excessive lipid accumulation in the liver, exacerbating steatotic changes. Adrenal gland disorders, particularly in the setting of chronic liver disease, impair cortisol metabolism and may worsen hepatic injury. Additionally, sex hormones such as estrogen and testosterone modulate the progression of liver fibrosis and influence the development of metabolic syndrome. The intricate relationship between endocrine and hepatic systems underscores the need for a multidisciplinary approach in the management of liver disease. Addressing underlying hormonal disturbances may enhance patient outcomes and prevent further hepatic deterioration. Future research should prioritize integrative therapeutic strategies that concurrently target endocrine and liver dysfunction.
内分泌紊乱常常导致显著影响肝功能的代谢紊乱。了解激素失衡与肝功能障碍之间的复杂相互作用对于推进靶向治疗策略至关重要。这篇全面综述探讨了将主要内分泌紊乱与肝脏疾病联系起来的病理生理机制，重点关注甲状腺、甲状旁腺、胰腺、肾上腺和性激素的作用。甲状腺功能障碍与肝酶水平和代谢调节的改变有关，常导致肝脂肪变性或胆汁淤积。甲状旁腺功能亢进及随之而来的高钙血症与肝脏钙化有关。肝脏和外周的胰岛素抵抗会导致肝脏中脂质过度积累，加剧脂肪变性变化。肾上腺疾病，特别是在慢性肝病背景下，会损害皮质醇代谢并可能加重肝损伤。此外，雌激素和睾酮等性激素会调节肝纤维化的进展并影响代谢综合征的发展。内分泌系统与肝脏系统之间的复杂关系强调了在肝病管理中采用多学科方法的必要性。解决潜在的激素紊乱问题可能会改善患者预后并防止肝脏进一步恶化。未来的研究应优先考虑同时针对内分泌和肝功能障碍的综合治疗策略。
