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Early shifts of adrenal steroidogenesis in male patients with liver cirrhosis
Kasr El-Aini Medical Journal. 2003; 9 (6): 209-220
em Inglês | IMEMR | ID: emr-118528
Biblioteca responsável: EMRO
ABSTRACT
Despite its positive effects on the secretion of cortisol, interleukin [IL]-6 suppresses adrenal androgen production. Adrenal androgens, particularly dehydroepiandrosterone [DHEA], may have important regulatory effects on the immune system in humans. It provides an immunostimulatory influence opposing the effect of glucocorticoids. As bacterial infection is likely to recur in cirrhotic patients with increased IL-6 levels, we hypothesized that sustained elevation of IL-6 levels in patients with liver cirrhosis might be associated with dysregulation of adrenal steroidogenesis and defective adrenal DHEA production. Forty-four male patients with hepatic cirrhosis [10 Pugh-Child's grade A, 17 grade B, and 17 grade C], and 10 healthy age-matched control male subjects were included in this study. Enzyme immunoassays were used for measurement of plasma adrenocorticotropic hormone [ACTH], serum cortisol, serum dehydroepiandrosterone sulfate [DHEAS], as a marker of DHEA production, and serum IL-6. Serum C-reactive protein [CRP] concentration was determined immunoturbidimetrically. Serum IL-6 and DHEAS showed significant change [increase in the former and decrease in the later] in cirrhotic patients with grades B and C as compared to healthy subjects [P<0.05]. Increased serum levels of cortisol and the cortisol/DHEAS molar ratio were found in the three groups of patients [grades A, B and C] in comparison to healthy subjects [P<0.05]. Child-Pugh's score was correlated positively with serum IL-6 [r=0.508, P=0.0004]; serum CRP [r=0.431 P=0.0035]; and serum cortisol [r=0.329, P=0.029]; and negatively with DHEAS/IL-6 ratio [r= -0.374, P=0.012]. Our results revealed that the severity of liver cirrhosis is associated with enhanced serum IL-6 and cortisol levels, and a decrease in serum DHEAS in relation to serum IL-6 concentrations. These perturbations accounted for the early shift of adrenal steroidogenesis to cortisol production at the expense of androgen production. This might participate in the increased susceptibility of cirrhotic patients for infectious complications. Future research should, therefore, focus on the evaluation of DHEA replacement in cirrhotic populations
Assuntos
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Base de dados: IMEMR Assunto principal: Hidrocortisona / Interleucina-6 / Desidroepiandrosterona / Testes de Função Hepática Limite: Humanos / Masculino Idioma: Inglês Revista: Kasr El-Aini Med. J. Ano de publicação: 2003
Buscar no Google
Base de dados: IMEMR Assunto principal: Hidrocortisona / Interleucina-6 / Desidroepiandrosterona / Testes de Função Hepática Limite: Humanos / Masculino Idioma: Inglês Revista: Kasr El-Aini Med. J. Ano de publicação: 2003
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