Assessment of adrenal function in liver diseases
Background: In recent times, there are reports of adrenal dysfunction in whole spectrum of liver disease. Adrenal insufficiency (AI) has been shown to correlate with progression of liver disease. Hence this study was conducted to assess adrenal function in subjects with acute liver disease (ALD), ch...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2013-01-01
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| Series: | Indian Journal of Endocrinology and Metabolism |
| Subjects: | |
| Online Access: | http://www.ijem.in/article.asp?issn=2230-8210;year=2013;volume=17;issue=3;spage=465;epage=471;aulast=Kharb |
| _version_ | 1811273109357985792 |
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| author | Sandeep Kharb M K Garg Pankaj Puri Bhaskar Nandi Karninder S Brar Abhay Gundgurthi Aditi Pandit |
| author_facet | Sandeep Kharb M K Garg Pankaj Puri Bhaskar Nandi Karninder S Brar Abhay Gundgurthi Aditi Pandit |
| author_sort | Sandeep Kharb |
| collection | DOAJ |
| description | Background: In recent times, there are reports of adrenal dysfunction in whole spectrum of liver disease. Adrenal insufficiency (AI) has been shown to correlate with progression of liver disease. Hence this study was conducted to assess adrenal function in subjects with acute liver disease (ALD), chronic liver disease (CLD) and post liver transplantation (LT). Material and Methods: This study included 25 healthy controls, 25 patients of ALD, 20 subjects of CLD with Child-Pugh stage A (CLD-1) and 30 with Child-Pugh stage B or C (CLD-2), and 10 subjects with LT. All subjects were assessed clinically, biochemically and for adrenal functions. Results: AI was present in 9 (34.6%) patients with ALD, 20 (40%) patients with CLD and 4 (40%) in subjects with LT. AI was more common in CLD-2 (18 patients - 60%) than CLD-1 (2 patients - 10%). All patients with chronic liver disease had significantly lower basal cortisol (8.8±4.8, P=0.01), stimulated cortisol (18.2±6.3, P <0.00001) and incremental cortisol (9.4±4.6, P <0.00001) as compared to controls. There was increase in percentage of subjects with adrenal dysfunction with progression of liver disease as assessed by Child-Pugh staging. AI was predicted by lower levels of serum protein, serum albumin, total cholesterol and HDL cholesterol and higher levels of serum bilirubin and INR. Adrenal functions showed recovery following liver transplantation. Conclusions: AI forms important part of spectrum of acute and chronic liver disease. Deterioration of synthetic functions of liver disease predicts presence of AI, and these patients should be evaluated for adrenal dysfunction periodically. |
| first_indexed | 2024-04-12T22:53:26Z |
| format | Article |
| id | doaj.art-4f11bf65bfcf4750870ef9c009810d99 |
| institution | Directory Open Access Journal |
| issn | 2230-8210 2230-9500 |
| language | English |
| last_indexed | 2024-04-12T22:53:26Z |
| publishDate | 2013-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Endocrinology and Metabolism |
| spelling | doaj.art-4f11bf65bfcf4750870ef9c009810d992022-12-22T03:13:17ZengWolters Kluwer Medknow PublicationsIndian Journal of Endocrinology and Metabolism2230-82102230-95002013-01-0117346547110.4103/2230-8210.111643Assessment of adrenal function in liver diseasesSandeep KharbM K GargPankaj PuriBhaskar NandiKarninder S BrarAbhay GundgurthiAditi PanditBackground: In recent times, there are reports of adrenal dysfunction in whole spectrum of liver disease. Adrenal insufficiency (AI) has been shown to correlate with progression of liver disease. Hence this study was conducted to assess adrenal function in subjects with acute liver disease (ALD), chronic liver disease (CLD) and post liver transplantation (LT). Material and Methods: This study included 25 healthy controls, 25 patients of ALD, 20 subjects of CLD with Child-Pugh stage A (CLD-1) and 30 with Child-Pugh stage B or C (CLD-2), and 10 subjects with LT. All subjects were assessed clinically, biochemically and for adrenal functions. Results: AI was present in 9 (34.6%) patients with ALD, 20 (40%) patients with CLD and 4 (40%) in subjects with LT. AI was more common in CLD-2 (18 patients - 60%) than CLD-1 (2 patients - 10%). All patients with chronic liver disease had significantly lower basal cortisol (8.8±4.8, P=0.01), stimulated cortisol (18.2±6.3, P <0.00001) and incremental cortisol (9.4±4.6, P <0.00001) as compared to controls. There was increase in percentage of subjects with adrenal dysfunction with progression of liver disease as assessed by Child-Pugh staging. AI was predicted by lower levels of serum protein, serum albumin, total cholesterol and HDL cholesterol and higher levels of serum bilirubin and INR. Adrenal functions showed recovery following liver transplantation. Conclusions: AI forms important part of spectrum of acute and chronic liver disease. Deterioration of synthetic functions of liver disease predicts presence of AI, and these patients should be evaluated for adrenal dysfunction periodically.http://www.ijem.in/article.asp?issn=2230-8210;year=2013;volume=17;issue=3;spage=465;epage=471;aulast=KharbAcute liver diseaseadrenal insufficiencychronic liver diseasecortisolliver transplantation |
| spellingShingle | Sandeep Kharb M K Garg Pankaj Puri Bhaskar Nandi Karninder S Brar Abhay Gundgurthi Aditi Pandit Assessment of adrenal function in liver diseases Indian Journal of Endocrinology and Metabolism Acute liver disease adrenal insufficiency chronic liver disease cortisol liver transplantation |
| title | Assessment of adrenal function in liver diseases |
| title_full | Assessment of adrenal function in liver diseases |
| title_fullStr | Assessment of adrenal function in liver diseases |
| title_full_unstemmed | Assessment of adrenal function in liver diseases |
| title_short | Assessment of adrenal function in liver diseases |
| title_sort | assessment of adrenal function in liver diseases |
| topic | Acute liver disease adrenal insufficiency chronic liver disease cortisol liver transplantation |
| url | http://www.ijem.in/article.asp?issn=2230-8210;year=2013;volume=17;issue=3;spage=465;epage=471;aulast=Kharb |
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