Evaluation of Adrenal Function in Nonhospitalized Patients with Cirrhosis
Background. Patients with cirrhosis and advancing hepatic insufficiency may show various degrees of other organ malfunction, including brain, kidney, and lung. Several studies have also shown a high prevalence of adrenal insufficiency in cirrhotic patients that may cause hemodynamic instability. Mat...
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| Format: | Article |
| Language: | English |
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Wiley
2017-01-01
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| Series: | Canadian Journal of Gastroenterology and Hepatology |
| Online Access: | http://dx.doi.org/10.1155/2017/2354253 |
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| author | Maryam Moini Mitra Yazdani Sarvestani Mesbah Shams Masood Nomovi |
| author_facet | Maryam Moini Mitra Yazdani Sarvestani Mesbah Shams Masood Nomovi |
| author_sort | Maryam Moini |
| collection | DOAJ |
| description | Background. Patients with cirrhosis and advancing hepatic insufficiency may show various degrees of other organ malfunction, including brain, kidney, and lung. Several studies have also shown a high prevalence of adrenal insufficiency in cirrhotic patients that may cause hemodynamic instability. Materials and Methods. In this study we prospectively evaluated adrenal function in a population of nonhospitalized cirrhotic patients. Categorization of liver disease severity was done according to model for end-stage liver disease (MELD) score. Adrenocorticotropic hormone stimulation testing was performed on subjects using 250 μg of synthetic short acting hormone; radio immunoassay was used to measure plasma cortisol levels. Results. Of 105 cirrhotic patients, 15.23% had evidence of adrenal insufficiency. These patients were not statistically different from those with normal adrenal function in levels of serum creatinine or bilirubin, MELD score, or presence of cirrhosis related complications. Significant differences were seen in mean international normalized ratio and serum sodium. Patients with a sodium level < 135 mEq/L had a higher rate (31.25%) of adrenal insufficiency. Conclusion. Adrenal dysfunction was identified in a population of stable nonhospitalized cirrhotic patients. Our results suggest a possible role for adrenal dysfunction as a contributing factor in hyponatremia in cirrhosis independent of other known factors of neurohormonal activation secondary to systemic vasodilation. |
| format | Article |
| id | doaj-art-fabe29b5461d4f3b9fab49b699a32878 |
| institution | Kabale University |
| issn | 2291-2789 2291-2797 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Canadian Journal of Gastroenterology and Hepatology |
| spelling | doaj-art-fabe29b5461d4f3b9fab49b699a328782025-02-03T05:59:42ZengWileyCanadian Journal of Gastroenterology and Hepatology2291-27892291-27972017-01-01201710.1155/2017/23542532354253Evaluation of Adrenal Function in Nonhospitalized Patients with CirrhosisMaryam Moini0Mitra Yazdani Sarvestani1Mesbah Shams2Masood Nomovi3Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Nemazee Hospital, Zand Street, Shiraz 71935-1311, IranDepartment of Internal Medicine, Fasa University of Medical Sciences, Ebne Sina Square, Fasa, IranEndocrinology and Metabolism Research Center, Shiraz University of Medical Sciences, Shiraz, IranDepartment of Internal Medicine, Shiraz University of Medical Sciences, Shiraz, IranBackground. Patients with cirrhosis and advancing hepatic insufficiency may show various degrees of other organ malfunction, including brain, kidney, and lung. Several studies have also shown a high prevalence of adrenal insufficiency in cirrhotic patients that may cause hemodynamic instability. Materials and Methods. In this study we prospectively evaluated adrenal function in a population of nonhospitalized cirrhotic patients. Categorization of liver disease severity was done according to model for end-stage liver disease (MELD) score. Adrenocorticotropic hormone stimulation testing was performed on subjects using 250 μg of synthetic short acting hormone; radio immunoassay was used to measure plasma cortisol levels. Results. Of 105 cirrhotic patients, 15.23% had evidence of adrenal insufficiency. These patients were not statistically different from those with normal adrenal function in levels of serum creatinine or bilirubin, MELD score, or presence of cirrhosis related complications. Significant differences were seen in mean international normalized ratio and serum sodium. Patients with a sodium level < 135 mEq/L had a higher rate (31.25%) of adrenal insufficiency. Conclusion. Adrenal dysfunction was identified in a population of stable nonhospitalized cirrhotic patients. Our results suggest a possible role for adrenal dysfunction as a contributing factor in hyponatremia in cirrhosis independent of other known factors of neurohormonal activation secondary to systemic vasodilation.http://dx.doi.org/10.1155/2017/2354253 |
| spellingShingle | Maryam Moini Mitra Yazdani Sarvestani Mesbah Shams Masood Nomovi Evaluation of Adrenal Function in Nonhospitalized Patients with Cirrhosis Canadian Journal of Gastroenterology and Hepatology |
| title | Evaluation of Adrenal Function in Nonhospitalized Patients with Cirrhosis |
| title_full | Evaluation of Adrenal Function in Nonhospitalized Patients with Cirrhosis |
| title_fullStr | Evaluation of Adrenal Function in Nonhospitalized Patients with Cirrhosis |
| title_full_unstemmed | Evaluation of Adrenal Function in Nonhospitalized Patients with Cirrhosis |
| title_short | Evaluation of Adrenal Function in Nonhospitalized Patients with Cirrhosis |
| title_sort | evaluation of adrenal function in nonhospitalized patients with cirrhosis |
| url | http://dx.doi.org/10.1155/2017/2354253 |
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