Hormonal Studies in Patients With Chronic Liver Disease

Pincus, I. J.; Rakoff, A. E.; Cohn, Edwin M.; Tumen, Henry J.

doi:10.1016/s0016-5085(19)36385-1

Cited by 51 publications

(8 citation statements)

References 56 publications

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“…Glass, Edmonson, and Soll (1940), Rupp, Cantarow, Rakoff, and Paschkis (1951), Pincus, Rakoff, Cohen, andTumen (1951), and Dohan, Richardson, Bluemle, and Gyorgy (1952), using bioassay methods, all found in approximately 48% of the patients studied values which usually were less than twice the normal maximum but occasionally were as high as seven times the normal. Later workers, using colorimetric measurements, have investigated a smaller number of patients and have found raised values in only approximately 20% of the cases, and no value has exceeded twice the normal maximum (Cameron, 1957;Lyngbye and Mogensen, 1961).…”

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confidence: 91%

Oestrogen metabolism and excretion in liver disease

Brown¹,

Crean²,

Ginsburg³

1964

Gut

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EDITORIAL SYNOPSIS Raised urinary oestrogen excretion was noted in 16 men and women with liver disease. The study suggests that the increased output of urinary oestrogens was usually due to increased secretion rates of the primary oestrogenic hormones rather than to impaired oestrogen metabolism by the liver.Numerous workers have reported a raised output of urinary oestrogens in men and women with various types of liver disease. Glass, Edmonson, and Soll (1940), Rupp, Cantarow, Rakoff, and Paschkis (1951), Pincus, Rakoff, Cohen, and Tumen (1951), and Dohan, Richardson, Bluemle, and Gyorgy (1952), using bioassay methods, all found in approximately 48% of the patients studied values which usually were less than twice the normal maximum but occasionally were as high as seven times the normal. Later workers, using colorimetric measurements, have investigated a smaller number of patients and have found raised values in only approximately 20% of the cases, and no value has exceeded twice the normal maximum (Cameron, 1957;Lyngbye and Mogensen, 1961). This raised output has been attributed to impaired metabolism by the diseased liver but evidence for this concept has been conflicting. Glass, Edmonson, and Soll (1944) administered oestrone and oestradiol to three patients with liver disease and recovered 83-86% of the biological activity of the administered dose in the urine whereas values of 10% would have been expected for normal individuals. On the other hand, Dohan et al. (1952) and Cameron (1957) measured endogenous urinary oestriol, oestrone, and oestradiol separately and found that the major urinary oestrogen in liver disease is often oestriol, which is the least biologically active of the three. After the administration of oestrone, oestradiol, or their esters to patients with liver disease, St0a, Bass0e, and Emberland (1958), in a study of five cases, found a decreased recovery as the three oestrogens in two and an increased recovery in one, and Lyngbye and 'Present address: Royal Women's Hospital, Melbourne, Australia. 2Present address:

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confidence: 91%

Oestrogen metabolism and excretion in liver disease

Brown¹,

Crean²,

Ginsburg³

1964

Gut

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“…Nevertheless, the hormonal mechanisms underlying the sexual dysfunction are poorly understood. Accordingly, in the few studies reported in chronic alcoholic women clinical and hormonal signs of both estrogen excess (26) and estrogen deficiency (27)(28)(29) were reported. Accordingly, in the few studies reported in chronic alcoholic women clinical and hormonal signs of both estrogen excess (26) and estrogen deficiency (27)(28)(29) were reported.…”

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Sex Hormones in Amenorrheic Women with Alcoholic Liver Disease

Välimäki

Pelkonen

Salaspuro

et al. 1984

The Journal of Clinical Endocrinology & Metabolism

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Urinary excretion of estrogens and plasma concentrations of estrone, estradiol, LH, FSH, PRL, progesterone, testosterone, and sex hormone binding globulin were measured in nine chronic alcoholic women with cirrhosis or alcoholic fatty liver. They were aged 24-40 yr and all had secondary amenorrhea which had lasted for at least 3 months. The response of pituitary gonadotropin secretion to administration of LHRH and estradiol benzoate and of PRL secretion to TRH were also investigated. Urinary excretion of estrogens in the alcoholic women with liver disease was similar to that in normal postmenopausal women and less than half that in normal women of the same age in the midfollicular phase of the menstrual cycle. Plasma estradiol levels in the alcoholic women were lower than in the menstruating women but higher than in the postmenopausal women, whereas their plasma estrone levels were higher than in the menstruating women. Plasma concentrations of progesterone and testosterone in the alcoholic women did not differ from those in the postmenopausal women but were lower than in the menstruating women. In spite of the relative estrogen deficiency plasma LH and FSH levels were not elevated in the alcoholic women. The responses of LH and FSH to LHRH were similar in the patients and in the menstruating women. Intramuscular administration of estradiol benzoate did not increase plasma LH and FSH concentrations in the alcoholic women. Hyperprolactinemia was not found and there were no differences in the PRL responses to TRH between the patients and the control groups. In conclusion, disturbed regulation of gonadotropin secretion is an important factor in the genesis of estrogen deficiency and amenorrhea in alcoholic women with liver disease, although ovarian function may also be directly impaired.

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“…Many of these workers concluded from their results that oestrogen excretion was raised in about half of their patients and that an important part of this increase was in the form of unconjugated oestrogen [Glass, Edmonson & Soil, 1940;Bennet, Bagenstoss & Butt, 1950;Rupp, Cantarow, Rakoff & Paschkis, 1951 ;Dohan, Richardson, Bluemlee & György, 1952]. A less constant increase in total oestrogen in male and post-menopausal female patients, with no increase in unconjugated oestrogen, was found by Pincus, Rakoff, Cohn & Turnen [1951].…”

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URINARY EXCRETION OF OESTRONE, OESTRADIOL-17β AND OESTRIOL IN PATIENTS WITH CHRONIC LIVER DAMAGE

Cameron¹

1957

Journal of Endocrinology

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The urinary excretion of oestrone, oestradiol-17\g=b\ and oestriol has been estimated by a chemical technique in nine men and three women with chronic liver disease.Combined oestrone, oestradiol and oestriol excretion was above normal limits in only two patients, both men. One excreted more than normal amounts of all three oestrogens; the other excreted more oestriol only. In addition, four men and one woman excreted more oestriol than normal, but this was not sufficient to increase the combined excretion of these three oestrogens beyond levels found in healthy controls. These findings are contrary to many published conclusions based on bioassay.Oestrogen excretion has been contrasted with the clinical findings. There was no correlation between increased oestrogen excretion and gynaecomastia. There was, however, a suggestive association of increased oestriol excretion, testicular atrophy, and a history of alcoholism. No association was established between an increased excretion of any oestrogen and the presence of ascites, jaundice, spider naevi and palmar erythema. Some implications of these findings are discussed.Patients with chronic liver disease frequently show alteration in their secondary sexual characteristics and sexual function. Men experience, at an early stage of their illness, loss of libido and diminished sexual potency, and clinical examination often reveals small testes, loss of axillary hair, and sometimes enlargement of the breasts.

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Hormonal Studies in Patients With Chronic Liver Disease

Cited by 51 publications

References 56 publications

Oestrogen metabolism and excretion in liver disease

Oestrogen metabolism and excretion in liver disease

Sex Hormones in Amenorrheic Women with Alcoholic Liver Disease

URINARY EXCRETION OF OESTRONE, OESTRADIOL-17β AND OESTRIOL IN PATIENTS WITH CHRONIC LIVER DAMAGE

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