Zietz, Bettina and Lock, Guntram and Plach, Barbara and Dropnik, Wolfgang and Grossmann, Johannes and Schoelmerich, Juergen and Straub, Rainer Hans (2003) Dysfunction of the hypothalamic-pituitary-glandular axes and relation to Child-Pugh classification in male patients with alcoholic and virus-related cirrhosis. EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY, 15 (5). pp. 495-501. ISSN 0954-691X, 1473-5687
Full text not available from this repository. (Request a copy)Abstract
Objective To investigate anterior pituitary function (adrenal, somatotropic, thyroid and gonadal axes, and prolactin) in relation to the Child-Pugh score in male patients with alcoholic and virus-related liver cirrhosis. Method Anterior pituitary function was evaluated in 52 male cirrhotics (26 Child-Pugh class A (CPA), 16 Child Pugh class B (CPB) and 10 Child-Pugh class C (CPC)) by a combined pituitary stimulation test, and was compared with 50 age-matched controls. Results A normal cortisol response to corticotropin-releasing hormone (CRH) stimulation was demonstrated in 57.6% of CPA patients, 31.1% of CPB patients and 20% of CPC patients, while basal levels of adrenocorticotropic hormone (ACTH) and cortisol in cirrhotics were comparable to those in controls. Levels of basal growth hormone (P< 0.001) and stimulated growth hormone (P< 0.01) were significantly higher in cirrhotics compared with controls, while levels of insulin-like growth factor 1 (IGF-1) were significantly lower (P< 0.001). Basal prolactin levels were elevated significantly in CPC patients (P< 0.01), while stimulated prolactin as well as basal and stimulated thyroid-stimulating hormone (TSH) levels were comparable. Basal luteinizing hormone levels were significantly higher in CPA (P< 0.001) and CPB (P< 0.001) patients, and stimulated luteinizing hormone levels were significantly lower in CPC patients than in controls (P< 0.005). Basal and stimulated follicle-stimulating hormone (FSH) levels were comparable in all groups. Child-Pugh score was correlated positively to prolactin and was correlated negatively to IGF-1, stimulated luteinizing hormone and free testosterone. Conclusions In cirrhotics, the hypothalamic-pituitary-adrenal and -gonadal axes and prolactin secretion are impaired. Growth hormone response to growth hormone-releasing hormone (GHRH) is accelerated in cirrhotics. Thus, elevated basal and stimulated levels of growth hormone probably reflect compensation for low levels of IGF-1, which are associated with deteriorating liver function. The aetiology of cirrhosis was found to have no influence on the degree of alteration of the hypothalamic-pituitary-glandular axes. EurJ Gastroenterol Hepatol 15: 495-501 (C) 2003 Lippincott Williams Wilkins.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | GROWTH-FACTOR-I; NONALCOHOLIC LIVER-DISEASE; TUMOR-NECROSIS-FACTOR; IDIOPATHIC HEMOCHROMATOSIS; BINDING-PROTEIN; FACTOR (IGF)-I; ADRENAL AXIS; HORMONE; CYTOKINES; DEHYDROEPIANDROSTERONE; anterior pituitary; ACTH; cirrhosis; gonadotropins; growth hormone; thyroid hormones; prolactin |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin I Medicine > Lehrstuhl für Klinische Chemie und Laboratoriumsmedizin |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 13 Sep 2021 08:26 |
| Last Modified: | 13 Sep 2021 08:26 |
| URI: | https://pred.uni-regensburg.de/id/eprint/39027 |
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