Jaime Olivo

Androgen metabolism in cirrhosis of the liver

Abstract Androgen metabolism was studied in male patients with cirrhosis of the liver. The plasma level, metabolic clearance, and production rates of testosterone were decreased while the conversion ratio and rate transport constant of testosterone to androstenedione was increased. Administration of testosterone produced a marked increase in the metabolic clearance rate of testosterone indicating that parenchymal hepatic dysfunction per se was not the cause for the reduced clearance rate. Moreover, the patients were found to have normal testicular reserve for the biosynthesis of testosterone as indicated by an almost fourfold increase in the plasma concentration of testosterone following the administration of human chorionic gonadotropin. These data demonstrate that the reduced production rate of testosterone in male cirrhotics is not due primarily to testicular disease but possibly reflects hypothalamic-pituitary suppression secondary to increased circulating estrogens. The increase in the rate of conversion of testosterone to androstenedione, found in the present study, is consistent with this hypothesis. The present investigation thus provides quantitative data on the hypogonadal state in cirrhosis and suggests possible mechanisms for the alteration in androgen metabolism.

Estrogen metabolism in hyperthyroidism and in cirrhosis of the liver

Estrogen metabolism was studied in spontaneous hyperthyroidism (Graves disease) and in alcoholic cirrhosis of the liver. The plasma concentration of estradiol-17beta (PCE2) was increased in men with hyperthyroidism. Although the metabolic clearance rate of estradiol-17beta (MCRE2) was reduced, the production rate (PR) of the steroid was increased above normal. The MCRE2 was also decreased in women with hyperthyroidism but the PCE2 and PRE2 was unchanged from normal. The conversion ratio of estradiol-17beta (CRE2E1) was increased in both hyperthyroid men and women. The PCE2 was significantly increased in men with cirrhosis of the liver. The MCRE2 was normal and this resulted in an increase in the PRE2 in this disorder. The CRE2E1 was significantly higher than normal. The plasma concentration of estrone (E1) was elevated in men with both disorders.

Studies of plasma beta-globulin: sex difference and effect of ethinyl estradiol and testosterone.

Summary A sex related difference in the concentration of protein in a β-globulin band, separated from plasma by starch gel electrophoresis, was found, with normal women (391 ± 49 (SD) mg/100 ml) having significantly higher levels than normal men (315 ± 53 mg/100 ml). Administration of estrogens to normal men significantly increased both the concentration of protein in the β-globulin band and the percentage binding of testosterone in plasma while the administration of testosterone to normal women produced the opposite effect. The findings suggest that the concentration of protein in the β-globulin band may be related, in part, to the effect of the sex steroids.

Virilizing luteoma of pregnancy: Report of a case with measurements of testosterone and testosterone binding in plasma

Abstract Virilizing luteoma of pregnancy with maternal and fetal virilization is reported in a 19 year old woman. Antepartum steroid determinations in the mother revealed an elevated urinary 17-ketosteroid excretion and markedly increased plasma testosterone levels. The percentage binding of testosterone in plasma was lower than expected for normal pregnancy. Surgical removal of the tumor resulted in complete regression of the signs of virilization in the mother and partial regression of the clitoral hypertrophy in the infant. These changes were associated with a return of the biochemical findings to normal.

Testosterone metabolism in endometrial cancer

Plasma testosterone (PCT), metabolic clearance (MCRT), and production rates (PRT) of testosterone and conversion ratio of testosterone to androstenedione (CRppTA) were performed on 11 patients with endometrial cancer and on a control group of five postmenopausal women. The PCT, MCRT, and PRT of patients with endometrial cancer are in the normal postmenopausal range. The conversion of testosterone to androstenedione in patients with endometrial cancer was significantly decreased.