Liver Function In Man Research Articles

(397) Long-term Testosterone Therapy in Men with Functional Hypogonadism and Obesity Improves Surrogate Parameters of Liver Function in a Urological Registry Study

Abstract Introduction Hepatic steatosis is highly prevalent in patients with hypogonadism and obesity. Fatty liver is increasingly recognized as cardiovascular risk factor. The gold standard assessment – histological evaluation of liver biopsies – cannot be performed in routine clinical practice. However, the fatty liver index (FLI) can be calculated using the formula by Bedogni: FLI = (e 0.953*loge (triglycerides) + 0.139*BMI + 0.718*loge (ggt) + 0.053*waist circumference - 15.745) / (1 + e 0.953*loge (triglycerides) + 0.139*BMI + 0.718*loge (ggt) + 0.053*waist circumference - 15.745) * 100 (Bedogni G et al. BMC Gastroenterol 2006;6:33). A FLI <30 rules out and a FLI ≥60 rules in fatty liver. Objective to investigate effects of long-term testosterone therapy (TTh) up to 13 years on surrogate parameters of liver function in men with functional hypogonadism and obesity in comparison to an untreated control group. Methods In an ongoing registry study in men with hypogonadism (total testosterone ≤350 ng/mL and at least moderate symptoms on the Aging Males’ Symptoms scale, AMS) in a single urology office, 491 men had functional hypogonadism and obesity (BMI ≥30 kg/m2). 292 men received testosterone undecanoate (TU) injections 1000 mg/12 weeks following an initial 6-week interval (T-group), 199 opted against TTh and served as controls (CTRL). Height was measured at baseline, weight, waist circumference, triglycerides and γ-GT were assessed at each visit and the fatty liver index (FLI) calculated. AST, ALT, and bilirubin were also measured at each visit. Mean absolute measures with standard deviations (SDs) are reported for a duration of 13 years. Results Mean (median) follow-up: T-group 10.1±3.1 (11), CTRL 9.4±3.3 (10) years. Baseline age was 59.5±6.0 (T-group) and 63.0±5.0 years (CTRL) (p<0.0001). Triglycerides decreased from 3.4±0.5 to 2.2±0.1 in the T-group and increased from 3.2±0.5 to 3.9±0.5 in CTRL (p<0.0001 for both). γ-GT (U/L) decreased from 42.9±22.8 to 20.5±6.4 in the T-group and increased from 35.5±11.6 to 61.7±5.9 in CTRL (p<0.0001 for both). AST (U/L) decreased from 38.4±13.3 to 20.8±1.9 in the T-group and increased from 28.6±9.0 to 54.1±11.9 in CTRL (p<0.0001 for both). ALT (U/L) decreased from 41.4±13.7 to 24.7±2.1 in the T-group and increased from 32.7±9.4 to 60.2±13.8 in CTRL (p<0.0001 for both). Bilirubin decreased from 0.53±0.27 to 0.18±0.05 mg/dL in the T-group and increased from 0.44±0.23 to 1.09±0.27 mg/dL in CTRL (p<0.0001 for both). Waist circumference from 115.0±13.2 to 97.5±4.6 cm in the T-group and increased from 118.6±11.4 to 121.2±6.1 cm in CTRL (p<0.0001 for all). BMI decreased from 36.8±3.6 to 28.3±2.1 kg/m2 in the T-group and increased from 33.9±3.3 to 34.9±2.2 kg/m2 in CTRL (p<0.0001 for all). FLI decreased from 95.1±4.6 to 61.3±11.2 in the T-group and increased from 94.1±4.4 to 98.0±1.3 in CTRL (p<0.0001 for both). Conclusions Long-term testosterone therapy in men with functional hypogonadism and obesity improved surrogate parameters of liver function indicating an improvement in hepatic steatosis. All measures deteriorated over time in untreated obese hypogonadal control patients. Disclosure Yes, this is sponsored by industry/sponsor: Bayer AG, Berlin, Germany. Clarification Industry funding only - investigator initiated and executed study. Any of the authors act as a consultant, employee or shareholder of an industry for: Bayer AG.

Effect of Circuit Resistance Training and L-Carnitine Supplementation on Body Composition and Liver Function in Men with Non-Alcoholic Fatty Liver Disease

Background: Exercises and L-carnitine supplementation are effective for liver function. Objectives: The purpose of this study was to compare effect of circuit resistance training and l-carnitine supplementation on body Composition and Liver Function in men with non-alcoholic fatty liver disease (NAFLD). Methods: In this semi-experimental study, 40 men with NAFLD were selected through purposive sampling and were randomly assigned to one of four groups includes: (1) resistance training, (2) supplement, (3) combined (exercise- supplement) and (4) control. Circuit resistance training was performed for 12 weeks, three sessions per week, with a training intensity of 40% - 80% maximum one-repetition. In the combined and supplementation group, 10 mg L-carnitine supplement per kg body weight was consumed daily with three main meals. To analyze the data, dependent t-test and one-way analysis of variance were used at P ≤ 0.05. Results: After exercise, there was a significant decrease in body mass index and body fat percentage in the resistance training group and combined (exercise-supplement) group when compared to the control and supplementation groups. There was also a significant decrease in the level of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in the intervention groups including exercise, supplement, and combined (exercise-supplement) groups compared to the control group. The percentage of changes in AST and ALT was significantly higher in the combined group than in the training and supplement groups. Conclusions: According to the findings of this study, circuit resistance and complementary L-carnitine training are effective for improving liver function. This improvement was more evident in the combination of training and L-carnitine supplementation, and these shifts are independent of changes in body composition.

Erectile function in men with end-stage liver disease improves after living donor liver transplantation.

BackgroundImpaired liver function in men can result in erectile dysfunction or hypogonadism or both. We investigated whether living donor liver transplantation (LDLT) results in improvement in male sexual function.MethodsA total of 58 patients with end-stage liver disease (ESLD) were included in this prospective, cross-sectional study. Erectile function was measured before and after LDLT using a five-item modified version of the International Index of Erectile Function scale (IIEF-5) and hypogonadism was evaluated before and after LDLT using the Androgen Deficiency in the Aging Male (ADAM) questionnaire. Differences in mean values from the questionnaires before and after the operation were than evaluated to determine whether there is an association between LDLT and improvement in sexual function.ResultsWe found that mean IIEF-5 scores significantly increased after LDLT (from 11.7 ± 7.7 before LDLT to 14.7 ± 7.5 after LDLT, p <0.01), indicating that the operation played a role in improving erectile function. In addition, the prevalence of hypogonadism among the patients with ESLD decreased markedly after liver transplantation (hypogonadism before LDLT, n = 41 versus hypogonadism after LDLT, n = 31, p = 0.03). Patients with hypogonadism reported a higher prevalence of erectile dysfunction after LDLT than patients without hypogonadism (p <0.01).ConclusionsLDLT results in improvement in erectile function. In addition, improvement in erectile function is associated with self-reported absence of hypogonadism.

Attempted to Estimate for the Recovery of Liver Function after Partial Hepatectomy by the Determination of 67Ga Accumulation into the Liver and Plasma Factor XIII Activity

Gallium-67 accumulation into the liver of partially hepatectomized rats reached a maximum 2 days after partial hepatectomy. The activity of plasma FXIII from hepatectomized rats reached a minimum (70% of levels in normalrats) 2 days after partial hepatectomy. Time course of plasma FXIII activity is inversely related to 6 7 Ga accumulation pattern. The determination of plasma FXIII activity is a simple and rapid diagnosis procedure and may be used for the estimation to the recover of the liver function after partial hepatectomy. The determination of 6 7 Ga accumulation into the liver after partial hepatectomy indicates the liver regenerating process but may be not proper for the imaging of regenerating liver function in man because of low liver-to-blood ratio.

The effect of folic acid on the drug metabolizing liver function in man with viral hepatitis

The investigations were carried out on 31 patients (16 men and 15 women, at the age of 20-50) with viral hepatitis. The all patients were divided at two groups. The first group (12 man) received usual treatment (diet, corsil), the second group (19 man) received in addition to the base treatment folic acid (5 mg per day, 10 days). It was found, that at patients with viral hepatitis was decreased the activity of monooxygenase system of liver. So, period of semielimination (T1/2) of antipyrine (AP) was greater in 1,4 time, area under the pharmacokinetic curve - 1,5 time and clearance was below by 39% than in volunteers (29 man). On day of treatment only by corsil, the rate of elimination of AP and clearance were increased by 34 and 31% (p < 0.05) respectively, T1/2 was decreased by 23% (p < 0.05) and area under the pharmacokinetic curve - 17 %. On 10 day of treatment by corsil with folic acid (5 mg per day), the rate of elimination of AP and clearance was increased by 43% (p < 0.05), area under the pharmacokinetic curve and T 1/2 were decreased by 30 and 33% (p < 0.05) respectively. The positive effect of folic acid in treatment of hepatitis at restoration period may be cause participating its derivatives in de novo nucleotide synthesis.

Relative cytotoxicity of psychotropic drugs in cultured rat hepatocytes.

The relative cytotoxic effects of ten psychotropic drugs were assessed in rat hepatocyte monolayer cultures. Clear concentration-related toxicity was seen in the narrow range of 10(-5) M to 5 X 10(-5) M. The four cytotoxicity endpoints chosen were: release of the cytosolic enzyme, lactate dehydrogenase, and impairment of biosynthesis and secretion of proteins, bile acids and glycerolipids. LDH leakage and inhibition of protein secretion into the culture medium proved to be the parameters which allowed the best differentiation between the test compounds. The inhibition of glycerolipid secretion was the most sensitive test in relation to concentration and time of exposure. Based on the effects of these endpoints, the following ranking of relative in vitro toxicity, using equimolar drug concentrations, could be established: clomipramine greater than imipramine = thioridazine greater than chlorpromazine greater than amitriptyline = fluperlapine greater than haloperidol greater than promazine greater than clozapine much greater than sulpiride. This ranking order of in vitro cytotoxicity correlated well with the potential of the drugs to impair liver function in man. Only clozapine had to be classified as a false negative. There was, however, no correlation between the cytotoxicity and the intracellular accumulation of the test drugs. Furthermore, the comparison of the data obtained with psychotropics with the data from five other amphiphilic cationic drugs was consistent with the widely accepted concept of a direct toxic interaction of the drugs with cytomembranes. This nonspecific toxicity of the membrane-active drugs was further corroborated by a positive correlation between their potential to induce LDH leakage in hepatocytes and their ability to induce hemolysis in red cells. In conclusion, the results obtained in our study strongly suggest that it is possible to assess the relative cytotoxicity of psychotropic drugs in rat hepatocyte cultures. It is proposed that this in vitro system provides a useful tool to evaluate new drugs at an early stage of their development, and to identify the most promising candidates within a class of structurally related compounds. In addition, it allows information to be obtained on possible mechanisms of cytotoxicity.

Serum testosterone concentrations in men with alcoholic cirrhosis: Background for variation

Median serum testosterone concentration of men with alcoholic cirrhosis (n = 216) did not differ significantly from normal controls (n = 51), but serum testosterone concentrations varied by a factor 43.9 in patients compared to 3.2 in controls ( P < .001). Nineteen percent of the patients had serum testosterone concentrations above 30 nmol/L. Serum concentrations of sex-hormone-binding globulin (SHBG) were significantly ( P < .001) raised, and serum concentrations of calculated nonprotein-bound and non-SHBG-bound testosterone were significantly ( P < .001) decreased in patients compared to normal control values. A number of background variables were analyzed with reference to serum testosterone concentrations by means of multiple regression techniques after having divided the patients into groups (A, B, C) with decreasing liver function by a modification of the Child-Turcotte's criteria. The only significant ( P < .01) background variables associated with log serum testosterone concentrations were: group C (β = −0.828), group B (β = −0.222), age (years) (β = −0.012), duration of hospitalization (days) (β = −0.0077), and concentration of SHBG (nmol/L) (β = 0.0044). Neither previous nor recent (within last six months) alcohol consumption influenced serum testosterone concentrations significantly, but about 50% of the patients had abstained from ethanol for two months or more. The same background variables as above were included as significantly ( P < .01) associated with log serum concentrations of calculated nonprotein-bound testosterone and calculated non-SHBG-bound testosterone, except that SHBG was insignificantly associated to any of the two proportions and that testicular volume was significantly ( P < .05) associated with log non-SHBG bound testosterone. Our data indicate that serum testosterone concentrations (total and nonbound) decreased significantly with decreasing liver function in men with alcoholic cirrhosis.

Intrinic hepatic clearance of ICG — A new quantitative measurement of liver function in man ?

Intrinic hepatic clearance of ICG — A new quantitative measurement of liver function in man ?

A comparison between oral and intravenous aminopyrine breath test in the evaluation of liver function in man

A comparison between oral and intravenous aminopyrine breath test in the evaluation of liver function in man

Hypothalamic-pituitary-gonadal function in relation to liver function in men with alcoholic cirrhosis.

Serum concentrations of oestrone, oestradiol, follicle-stimulating hormone (FSH), luteinizing hormone (LH), and sex hormone-binding globulin (SHBG) were significantly (P less than 0.01) raised in men with alcoholic liver cirrhosis (no. = 42) compared with age-matched controls (no. = 20). No significant difference was observed when comparing serum testosterone concentrations. Patients were divided into three groups in accordance with the severity of liver cirrhosis, using biochemical and clinical criteria. Patients with the best-preserved liver function (no. = 11) and patients with moderately affected liver function (no. = 18) had significantly (P less than 0.05) raised serum concentrations of testosterone, FSH, and LH when compared with both controls and patients with severely affected liver function (no. = 13). Serum concentrations of testosterone, FSH, and LH in the latter group showed no significant differences from the controls. Serum concentrations of oestrone and oestradiol were significantly (P less than 0.05) increased in all patient groups, and serum oestrone increased with decreasing liver function. No significant differences were observed concerning SHBG concentrations in the three groups of patients. Dexamethasone suppression did not change the concentration of testosterone significantly, but oestrone and oestradiol concentrations decreased significantly (P less than 0.01) in controls and patients. In patients, but not in controls, a significant (P less than 0.01) increase in FSH and LH concentrations was observed after dexamethasone suppression. The mean percentage increase of FSH and LH was higher the greater the severity of liver cirrhosis.

Oral testosterone load related to liver function in men with alcoholic liver cirrhosis.

The relation between liver function and an oral testosterone load was examined in 42 consecutive patients with alcoholic liver cirrhosis. Administration of an oral load of 400 mg micronized free testosterone increased the serum concentration of testosterone (range, 31.9-694.4 nmol/l; median, 140.8 nmol/l) in male patients with alcoholic liver cirrhosis to significantly (P less than 0.01) higher levels than in male subjects without liver disease (range, 25.4-106.6 nmol/l; median, 61.5 nmol/l). The increase of testosterone after the load (log delta testosterone) in patients correlated inversely with galactose elimination capacity (r = 0.54; P less than 0.001), serum albumin (r = -0.53; P less than 0.001), plasma factor II + VII + X (r = 0.62; P less than 0.001), indocyanine green clearance (r = -0.71; P less than 0.001), and hepatic blood flow (r = -0.61; P less than 0.01) and correlated directly with wedged-to-free hepatic vein pressure (r = +0.54; P less than 0.01). The increase of testosterone after the load did not correlate significantly with sex hormone-binding globulin (r = +0.35; P greater than 0.05). It is concluded that the hepatic extraction of testosterone is significantly decreased in patients with alcoholic cirrhosis. This decrease seems to be due to decreased liver function, decreasing hepatic blood flow, and increased portosystemic shunting. Oral testosterone loading may therefore be of prognostic significance in patients with alcoholic liver cirrhosis.

The effect of excess vitamin A on the development of rat embryos in culture

ABSTRACT Primitive streak stage rat embryos were cultured in serum containing added vitamin A alcohol at concentrations ranging from 0·5 to 20 μg/ml. At the higher concentrations there was an overall growth retardation, and differentiation was inhibited. This was thought to be due to inhibition of DNA synthesis. At 0· 5 μg/ml the embryos developed abnormally in a manner similar to that previously seen in vivo. This result, which was supported by an ultra-structural study, provides evidence that the teratogenic effects of vitamin A are due to a direct action on the embryos. Comparison of embryonic development in vitro at different concentrations of vitamin A with the results obtained in vivo suggests that in the latter, only a very small proportion of the amount injected was reaching the embryos in an active form. The maternal factors involved are discussed, and excess vitamin A is defined as an excess of free and non-specifically bound retinol. The levels of vitamin A which affected differentiating embryos in vitro are lower than the minimum levels previously shown to affect differentiated tissues. This suggests that relatively minor increases in serum levels during pregnancy may cause malformations without affecting the maternal organism. Since raised serum vitamin A levels have been shown to be associated with impaired liver function in man, these factors may be significant in human teratogenesis.

Effect of rifampicin on liver function in man.

Liver function and serum concentrations of rifampicin, a highly cholephilic antibiotic, have been studied after ingestion of a single dose of 600 mg of rifampicin in 12 patients, six of them having a normal liver and six a cirrhotic, and during treatment with 600 mg of rifampicin per day for 17 days in eight patients, four of them having a normal liver and four a cirrhotic. Rifampicin produced competition for the elimination of bilirubin and bromsulphalein by the liver. This competition, which seemed to involve mainly the uptake by the liver cell, was always rapidly reversible when treatment was discontinued. It makes it impossible, however, to interpret a bromsulphalein test during treatment with rifampicin. In the eight patients treated for 17 days, apart from the competition already mentioned, no clinical, biological, or morphological abnormalities of the liver were ascertained. But in this limited number of patients it is not possible to exclude the fact that rifampicin could provoke jaundice by idiosyncrasy in a small percentage of cases. The serum concentrations of rifampicin were higher in cirrhotic patients than in patients with normal livers, especially after one or two weeks of treatment. It is suggested that efficient blood concentrations of rifampicin would be achieved with small doses in case of previous hepatocellular insufficiency.

A COMPARISON OF THE EFFECTS OF CHLOROFORM AND HALOTHANE ON LIVER FUNCTION.

AnaesthesiaVolume 20, Issue 1 p. 66-69 Free Access A comparison of the effects of chloroform and halothane on liver function M.J. KIRWAN mb, bs, ffarcs, M.J. KIRWAN mb, bs, ffarcs Department of Anæsthetics The Queen's University of Belfast Northern IrelandSearch for more papers by this authorJ.W. DUNDEE md, phd, ffarcs, J.W. DUNDEE md, phd, ffarcs Department of Anæsthetics The Queen's University of Belfast Northern IrelandSearch for more papers by this authorD.W. NEILL msc, mcpath, fric, D.W. NEILL msc, mcpath, fric Department of Anæsthetics The Queen's University of Belfast Northern IrelandSearch for more papers by this author M.J. KIRWAN mb, bs, ffarcs, M.J. KIRWAN mb, bs, ffarcs Department of Anæsthetics The Queen's University of Belfast Northern IrelandSearch for more papers by this authorJ.W. DUNDEE md, phd, ffarcs, J.W. DUNDEE md, phd, ffarcs Department of Anæsthetics The Queen's University of Belfast Northern IrelandSearch for more papers by this authorD.W. NEILL msc, mcpath, fric, D.W. NEILL msc, mcpath, fric Department of Anæsthetics The Queen's University of Belfast Northern IrelandSearch for more papers by this author First published: January 1965 https://doi.org/10.1111/j.1365-2044.1965.tb02479.xCitations: 3AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL References 1 GRIFFITHS, H.W.C. and OZGUC, L. (1964). Effects of chloroform and halothane anæsthesia on liver function in man. Lancet, i, 246. (Preliminary communication). 2 VIRTUE, R.W. and PAYNE, K.W. (1958). Postoperative death after fluothane. Anesthesiology, 19, 562. 3 MICHEL, H.O. (1949). An electrometric method for the determination of red blood cell and plasma cholinesterase activity. J. Lab. clin. Med., 34, 1564. 4 KING, J. (1960). A study of human serum transaminases. J. med. Lab. Technol., 17, 1. 5 STEPHEN, C.R., MARGOLIS, G., FABIAN, L.W. and BURGEOIS-GAVARDIN, M. (1958). Laboratory observations with fluothane. Anesthesiology, 19, 770. 6 IMRAY, J. MCG., KENNEDY, B.R. and KILPATRICK, S.J. (1964). The effect of brief chloroform administration on liver function. Anæsthesia, 19, 33. Citing Literature Volume20, Issue1January 1965Pages 66-69 ReferencesRelatedInformation

INTRAVENOUS PROCAINE: ITS EFFECT ON LIVER FUNCTION IN MAN AS DETERMINED BY THE CEPHALIN FLOCCULATION TEST

INTRAVENOUS PROCAINE: ITS EFFECT ON LIVER FUNCTION IN MAN AS DETERMINED BY THE CEPHALIN FLOCCULATION TEST

PHYSIOLOGY OF THE LIVER

The following methods are employed in the investigation of liver function in man and in animals: The secretory or excretory functions of the liver can be investigated by biliary fistulas in man and in animals or in acute experiments in animals by collecting the bile direct from the duct. Thus, the chemistry of the bile both in the gallbladder and as directly secreted by the liver has been investigated and is approximately known. The same method yields data with reference to secretagogues that may stimulate production of bile, the relation of foods to bile secretion, and in acute experiments it is possible to study the evacuation mechanisms of the duct and gallbladder systems aside from the production of bile by the liver cells. In acute experiments it is possible to collect portal and hepatic blood both during digestion and in fasting. This method has yielded important data on the liver