Abstract

Patients with liver disease present many of the features of 'feminized' hepatic metabolism. Oestrogens exert their effects through interaction with specific cellular high-affinity receptors (ER). We measured hepatic ER in 102 needle biopsies from patients with chronic alcoholic and non-alcoholic liver disease using an enzyme immunoassay. Fifteen patients with no or minimal changes in liver histology served as controls. The hepatic ER concentrations were significantly (P = 0.05) lower in the 44 men (median 13 fmol mg-1 protein, interquartile range 7-17 fmol mg-1 protein) compared to the 58 women (median 15 fmol mg-1 protein, interquartile range 10-21 fmol mg-1 protein). Patients with alcoholic liver disease (n = 63) had significantly (P < 0.05) lower ER concentrations than controls (n = 15) (median 13 fmol mg-1 protein, interquartile range 7-17 fmol mg-1 protein vs. median 16 fmol mg-1 protein, interquartile range 10-26 fmol mg-1 protein), and compared with patients with non-alcoholic liver disease (n = 24) (P < 0.05, median 20 fmol mg-1 protein, interquartile range 11-24 fmol mg-1 protein). ER concentrations were significantly lower (P < 0.05) in patients with alcoholic liver disease and alcoholic hepatitis (n = 21) compared to those without alcoholic hepatitis (n = 42) (medians 10 vs. 14 fmol mg-1 protein, interquartile ranges 6-15 fmol mg-1 protein vs. 9-18 fmol mg-1 protein), while ER concentrations did not differ significantly (P > 0.05) between actively drinking (median 13 fmol mg-1 protein, interquartile range 7-17 fmol mg-1 protein) and abstaining alcoholic patients (median 13 fmol mg-1 protein. interquartile range 7-18 fmol mg-1 protein). In summary, the small but significant variation in hepatic ER concentrations reflects variation in liver function rather than an effect of ethanol.

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