An evaluation of the respective roles of portosystemic shunting and portal hypertension in rats upon the production of gonadal dysfunction in cirrhosis.

To evaluate the differential effects of portal hypertension and portosystemic shunting upon the endocrine changes that occur in men with advanced chronic liver disease, male rats underwent either partial portal vein ligation or direct portocaval anastomosis. Testicular mass was found to be reduced in both models (p less than 0.05). Similarly, estradiol levels were found to be increased (p less than 0.05) in both models when compared with sham-operated controls. The increase in estradiol levels was greater in the animals with a complete shunt than in those animals with incomplete shunts developed as a consequence of portal hypertension (p less than 0.05). Luteinizing hormone levels were reduced (p less than 0.01) in the animals with the greater estradiol levels. As expected, testosterone levels were reduced (p less than 0.01) only in the animals with reduced luteinizing hormone levels. These data suggest that portosystemic shunting, and not portal hypertension per se, is responsible, at least in part, for the gonadal injury that occurs with advanced liver disease.