Study of Gonadal Hormones in Males With Liver Cirrhosis and Its Correlation With Child-Turcotte-Pugh and Model for End-Stage Liver Disease Scores

Background and aims: Liver cirrhosis influences gonadal hormone metabolism by multiple mechanisms and causes gonadal dysfunction. This study aimed to study sex hormones in males with cirrhosis and determine their correlation with prognostic scores. Methods: An observational study was conducted between October 2019 and August 2021 in India. Sixty males with liver cirrhosis and 60 healthy age-matched controls were enrolled. Serum-free testosterone (T), estradiol (E2), follicle-stimulating hormone (FSH), luteinizing hormone (LH), and prolactin (Prl) were checked. Child-Turcotte-Pugh (CTP) and model for end-stage liver disease (MELD-Na) scores were calculated. Results: Mean age of patients was 46.9±8.38 years. Forty-three were alcoholics. A total of 29 (48.33%) patients had low levels of free T. Cirrhotic males had lower testosterone and higher estradiol levels and lower T:E2 ratio compared to controls. Levels of luteinizing hormone, follicle-stimulating hormone, and prolactin were comparable. Lower testosterone was significantly associated with advancing age, alcoholism, duration of cirrhosis, loss of libido, and ascites. The higher the CTP scores, the lower the free testosterone levels and the higher the E2 levels. There was no significant association between low free testosterone levels and MELD-Na score. Conclusions: Age, alcohol, duration of disease, and low albumin levels are risk factors for hypogonadism in cirrhosis. There was a significant positive correlation between low free testosterone levels and poor CTP scores.