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Sexualhormone und Hypophysen-Gonadenachse bei Frauen mit Leberzirrhose in der Postmenopause

Sexual hormones and hypophyseal gonadal axis in postmenopausal women with cirrhosis of the liver

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Summary

The hormonal status of men with cirrhosis of the liver has been investigated in numerous studies. Little, however, is known about changes of sexual hormones in women afflicted by this disorder. In a study of 31 postmenopausal women (mean age 63±8 years) suffering from cirrhosis of various etiology (alcoholic,n=8; posthepatitic B,n=1; PBC,n=5; cryptogenetic,n=17) the blood levels of estradiol (E2), estrone (E1), androstenedione (A), testosterone (T) and basal and stimulated values of gonadotropins are reported and compared with the data obtained in an agematched control group (n=9). In cirrhosis a significant increase of the median E2 (28 vs 12 pg/ml,P<0.01) was found, whereas the changes of the blood levels of E1 (88 vs 76 pg/ml), A (63 vs 111 ng/dl), and T (0.30 vs 0.15 ng/ml) did not attain statistical significance in comparison to controls. Within the study group, however, a significant positive correlation with the degree of decompensation of cirrhosis (Childscore A–C) was observed for the steroid hormones measured. Thus, in subgroup C the hormone levels are higher than physiologically expected for postmenopausal women. On the other hand the median FSH (32 vs 48 mU/ml,P<0.05) is significantly lower in cirrhosis compared to controls with a trend to decreased values of LH. Very low levels of LH and FSH are found in decompensated cirrhosis. The decrease of LH and FSH can partly be explained by the rise of peripheral hormones (i.e. E2, E1, and in some cases T and A). The response of the gonadotropins to stimulation by 100 µg GnRh generally remains unimpaired. Only a few women with decompensated cirrhosis show a hormonal profile (low gonadotropins in spite of low sexual hormones, reduced stimulation after GnRh) that indicates a disturbance of hypophyseal regulation as a result of a central defect of possible hypothalamic origin.

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Abbreviations

A:

Androstendion

E1:

östron

E2:

östradiol

FSH:

Follikel stimulierendes Hormon

GnRh:

Gonadotropin Releasinghormon

K:

Kontrollen

LH:

Luteotropes Hormon

LZ:

Leberzirrhose

n:

Anzahl der Personen

PBC:

Primär biliäre Zirrhose

T:

Testosteron

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Authors and Affiliations

  1. Zentrum für Innere Medizin der Universität Marburg Abteilung Endokrinologie und Stoffwechsel, Germany

    R. Grün, Ch. Günther & H. Kaffarnik

  2. Medizinische Klinik Prosper-Hospital, Mühlenstr, D-4350, Recklinghausen

    R. Grün

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Grün, R., Günther, C. & Kaffarnik, H. Sexualhormone und Hypophysen-Gonadenachse bei Frauen mit Leberzirrhose in der Postmenopause. Klin Wochenschr 65, 411–418 (1987). https://doi.org/10.1007/BF01715763

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