Patterns of hypothalamic-pituitary-gonadal dysfunction in men with liver disease due to differing etiologies

Authors

  • Dr. David H. van Thiel M.D.,

    Corresponding author
    1. Divisions of Gastroenterology and Coagulation of the Department of Medicine and Division of Clinical Chemistry of the Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15261
    • 1000 J Scaife Hall, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15261
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    • Dr. Van Thiel is the recipient of a United States Public Health Service Career Development Award AA000016.

  • Judith S. Gavaler,

    1. Divisions of Gastroenterology and Coagulation of the Department of Medicine and Division of Clinical Chemistry of the Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15261
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  • Joel A. Spero M.D.,

    1. Divisions of Gastroenterology and Coagulation of the Department of Medicine and Division of Clinical Chemistry of the Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15261
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  • Kimberley M. Egler,

    1. Divisions of Gastroenterology and Coagulation of the Department of Medicine and Division of Clinical Chemistry of the Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15261
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  • Carl Wight,

    1. Divisions of Gastroenterology and Coagulation of the Department of Medicine and Division of Clinical Chemistry of the Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15261
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  • Ajitkumar T. Sanghvi Ph.D.,

    1. Divisions of Gastroenterology and Coagulation of the Department of Medicine and Division of Clinical Chemistry of the Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15261
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  • Ute Hasiba M.D.,

    1. Divisions of Gastroenterology and Coagulation of the Department of Medicine and Division of Clinical Chemistry of the Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15261
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  • Jessica H. Lewis M.D.

    1. Divisions of Gastroenterology and Coagulation of the Department of Medicine and Division of Clinical Chemistry of the Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15261
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Abstract

The hypothalamic-pituitary-gonadal axis was evaluated in two groups of age-matched men with documented biochemical and histologic liver disease and compared to that of age-matched normal controls. Basal testosterone levels (p < 0.05), spermatozoa concentrations (p < 0.01), and seminal plasma volume (p < 0.01) were reduced in the alcoholics studied with liver disease, but not the hemophiliacs with liver disease when compared to the normal controls. No difference in estradiol levels was noted between groups. Basal follicle-stimulating hormone and luteinizing hormone (LH) concentrations were increased (both p < 0.01) in the alcoholics while only LH concentrations were increased (p < 0.01) in the hemophiliacs compared to the normal controls. Gonadotropins (folliclestimulating hormone and LH) and testosterone responses to clomiphene and to luteinizing hormone-releasing factor (LH only) in the alcoholic population studied, further distinguished the alcoholics from the hemophiliacs and the normal controls. The basal levels of the other anterior pituitary hormones (growth hormone and thyroid-stimulating hormone) as well as their provocative responses to thyrotropin-releasing hormone also distinguished the alcoholics from the hemophiliac population. Based upon these results, we propose that factors other than the liver disease per se are responsible for the disturbances of hypothalamic-pituitary-gonadal function observed in men with biochemically as well as histologically advanced stable liver disease.

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