{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T21:23:52Z","timestamp":1791235432747,"version":"4.1.0"},"reference-count":41,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,10,31]],"date-time":"2018-10-31T00:00:00Z","timestamp":1540944000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Hepatology Research"],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>Endocrinological abnormalities, including low testosterone levels, are prevalent in cirrhosis. We assessed sexual hormone status in regard to hemodynamic abnormalities and its impact on hepatic decompensation and survival.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Males with cirrhosis were prospectively included in this study since 2010. Sexual hormones including bioavailable testosterone, total testosterone, luteinizing hormone, follicle\u2010stimulating hormone, prolactin, and sex hormone\u2010binding globulin as well as Child\u2013Pugh score, Model for End\u2010stage Liver Disease (MELD) score, and hepatic venous pressure gradient were recorded. Sarcopenia was also assessed in patients with available computed tomography scans. Clinical follow\u2010up for hepatic decompensation, liver transplantation, and death was recorded until May 2017.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred fourteen male cirrhotic patients were included: age 55\u2009\u00b1\u20099.4\u00a0years, MELD 13.5 (range, 7\u201320.7). Etiologies were alcoholic liver disease in 61(53.5%) patients, viral in 30 (26.3%) patients, and other in 23 (20.2%). Child\u2013Pugh scores were A in 32 (28.1%) patients, B in 48 (42.1%), and C in 34 (29.8%). Levels of bioavailable testosterone and total testosterone decreased with advanced Child\u2013Pugh score (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001 and <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) whereas prolactin increased (<jats:italic>P<\/jats:italic>\u2009=\u20090.002). Median bioavailable testosterone (0.8\u00a0ng\/mL [0.1\u20132] vs. 1.68\u00a0ng\/mL [0.07\u20132.65]; <jats:italic>P<\/jats:italic>\u2009=\u20090.004) and total testosterone (2.7\u00a0ng\/mL [0.23\u201312.34] vs. 7\u00a0ng\/mL [0.25\u201310]; <jats:italic>P<\/jats:italic>\u2009=\u20090.041) levels were lower in patients with severe portal hypertension (hepatic venous pressure gradient &gt;12\u00a0mmHg). Median bioavailable testosterone (0.25\u00a0ng\/mL [0.07\u20131.7] vs. 0.97\u00a0ng\/mL [0.15\u20132.74)]; <jats:italic>P<\/jats:italic>\u2009=\u20090.017) and total testosterone levels (1.28\u00a0ng\/mL [0.25\u20137.32] vs. 4.32\u00a0ng\/mL [0.43\u201313.47]; <jats:italic>P<\/jats:italic>\u2009=\u20090.031) were significantly lower in sarcopenic patients. Median follow\u2010up was 13\u00a0months (0.2\u201375\u00a0months) and liver\u2010related events were recorded in 46 patients (40.4%; death, 31 [27.2%]). Low total testosterone was associated with an increased risk for hepatic decompensation and\/or death, even after adjusting for Child\u2013Pugh score, MELD, and other relevant factors (Child\u2013Pugh score model: hazard ratio 2.503, 95% confidence interval, 1.214\u20135.157, <jats:italic>P<\/jats:italic>\u2009=\u20090.013; MELD model: hazard ratio 3.065, 95% confidence interval, 1.523\u20136.169, <jats:italic>P<\/jats:italic>\u2009=\u20090.002).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In parallel to increasing severity of cirrhosis, levels of testosterone decline whereas prolactin levels increase. However, low testosterone levels are independently associated with a higher risk for hepatic decompensation and mortality.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hepr.13253","type":"journal-article","created":{"date-parts":[[2018,9,24]],"date-time":"2018-09-24T18:18:20Z","timestamp":1537813100000},"page":"201-211","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Dysbalanced sex hormone status is an independent predictor of decompensation and mortality in patients with liver cirrhosis"],"prefix":"10.1111","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1813-5769","authenticated-orcid":false,"given":"Rafael","family":"Paternostro","sequence":"first","affiliation":[{"name":"Vienna Hepatic Hemodynamic Laboratory, Divison of Gastroenterology and Hepatology, Department of Internal Medicine III Medical University of Vienna  Vienna Austria"},{"name":"Divison of Gastroenterology and Hepatology, Department of Internal Medicine III Medical University of Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birgit B.","family":"Heinisch","sequence":"additional","affiliation":[{"name":"Vienna Hepatic Hemodynamic Laboratory, Divison of Gastroenterology and Hepatology, Department of Internal Medicine III Medical University of Vienna  Vienna Austria"},{"name":"Divison of Gastroenterology and Hepatology, Department of Internal Medicine III Medical University of Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Reiberger","sequence":"additional","affiliation":[{"name":"Vienna Hepatic Hemodynamic Laboratory, Divison of Gastroenterology and Hepatology, Department of Internal Medicine III Medical University of Vienna  Vienna Austria"},{"name":"Divison of Gastroenterology and Hepatology, Department of Internal Medicine III Medical University of Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mattias","family":"Mandorfer","sequence":"additional","affiliation":[{"name":"Vienna Hepatic Hemodynamic Laboratory, Divison of Gastroenterology and Hepatology, Department of Internal Medicine III Medical University of Vienna  Vienna Austria"},{"name":"Divison of Gastroenterology and Hepatology, Department of Internal Medicine III Medical University of Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Constanze","family":"Bardach","sequence":"additional","affiliation":[{"name":"Department of Biomedical Imaging and Image\u2010guided Therapy Medical University of Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Lampichler","sequence":"additional","affiliation":[{"name":"Department of Biomedical Imaging and Image\u2010guided Therapy Medical University of Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berit","family":"Seeland","sequence":"additional","affiliation":[{"name":"Vienna Hepatic Hemodynamic Laboratory, Divison of Gastroenterology and Hepatology, Department of Internal Medicine III Medical University of Vienna  Vienna Austria"},{"name":"Divison of Gastroenterology and Hepatology, Department of Internal Medicine III Medical University of Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Remy","family":"Schwarzer","sequence":"additional","affiliation":[{"name":"Vienna Hepatic Hemodynamic Laboratory, Divison of Gastroenterology and Hepatology, Department of Internal Medicine III Medical University of Vienna  Vienna Austria"},{"name":"Divison of Gastroenterology and Hepatology, Department of Internal Medicine III Medical University of Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Trauner","sequence":"additional","affiliation":[{"name":"Divison of Gastroenterology and Hepatology, Department of Internal Medicine III Medical University of Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Peck\u2010Radosavljevic","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology, Endocrinology and Nephrology Klinikum Klagenfurt am W\u00f6rthersee  Klagenfurt Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnulf","family":"Ferlitsch","sequence":"additional","affiliation":[{"name":"Vienna Hepatic Hemodynamic Laboratory, Divison of Gastroenterology and Hepatology, Department of Internal Medicine III Medical University of Vienna  Vienna Austria"},{"name":"Divison of Gastroenterology and Hepatology, Department of Internal Medicine III Medical University of Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,10,31]]},"reference":[{"key":"e_1_2_5_2_1","first-page":"495","article-title":"Dysfunction of the hypothalamic\u2013pituitary\u2013glandular axes and relation to Child\u2013Pugh classification in male patients with alcoholic and virus\u2010related cirrhosis","volume":"15","author":"Zietz B","year":"2003","journal-title":"Eur J Gastroenterol Hepatol"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.17.5.345"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1530\/acta.0.1200271"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1439-0272.1985.tb00961.x"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF03346393"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.13122"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.12695"},{"key":"e_1_2_5_9_1","first-page":"531","article-title":"Gonadal dysfunction and changes in sex hormones in postnecrotic cirrhotic men: a matched study with alcoholic cirrhotic men","volume":"38","author":"Wang YJ","year":"1991","journal-title":"Hepatogastroenterology"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.1995.tb02040.x"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2265.1996.698519.x"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(01)00052-6"},{"key":"e_1_2_5_13_1","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1016\/S0016-5085(83)80242-X","article-title":"An evaluation of the respective roles of portosystemic shunting and portal hypertension in rats upon the production of gonadal dysfunction in cirrhosis","volume":"85","author":"Van Thiel DH","year":"1983","journal-title":"Gastroenterology"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2012.04347.x"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.24607"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-230X-12-69"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2005-861464"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00508-013-0337-z"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2010.05.004"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2006.01.018"},{"key":"e_1_2_5_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0261-5614(97)80022-2"},{"key":"e_1_2_5_22_1","doi-asserted-by":"publisher","DOI":"10.1210\/jcem.84.10.6079"},{"key":"e_1_2_5_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.25806"},{"key":"e_1_2_5_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.12783"},{"key":"e_1_2_5_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/hepr.12774"},{"key":"e_1_2_5_26_1","first-page":"32","article-title":"Pituitary function test and endocrine status in patient with cirrhosis of the liver before and after hepatic transplantation","volume":"7","author":"Seehofer D","year":"2002","journal-title":"Ann Transplant"},{"key":"e_1_2_5_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.13122"},{"key":"e_1_2_5_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/00042737-199703000-00012"},{"key":"e_1_2_5_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.13182"},{"key":"e_1_2_5_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2016.06.007"},{"key":"e_1_2_5_31_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2005-1097"},{"key":"e_1_2_5_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajhb.20419"},{"key":"e_1_2_5_33_1","doi-asserted-by":"publisher","DOI":"10.1186\/1742-2094-5-32"},{"key":"e_1_2_5_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2012.12.011"},{"key":"e_1_2_5_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2009.03713.x"},{"key":"e_1_2_5_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2011.08.028"},{"key":"e_1_2_5_37_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v21.i25.7637"},{"key":"e_1_2_5_38_1","article-title":"EASL Clinical Practice Guidelines on nutrition in chronic liver disease","author":"European Association for the Study of the Liver","year":"2018","journal-title":"J Hepatol"},{"key":"e_1_2_5_39_1","doi-asserted-by":"publisher","DOI":"10.1007\/s005350200082"},{"key":"e_1_2_5_40_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02774169"},{"key":"e_1_2_5_41_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2011-1617"},{"key":"e_1_2_5_42_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2011-1137"}],"container-title":["Hepatology Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fhepr.13253","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hepr.13253","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,14]],"date-time":"2023-09-14T06:59:37Z","timestamp":1694674777000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hepr.13253"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,10,31]]},"references-count":41,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2019,2]]}},"alternative-id":["10.1111\/hepr.13253"],"URL":"https:\/\/doi.org\/10.1111\/hepr.13253","archive":["Portico"],"relation":{},"ISSN":["1386-6346","1872-034X"],"issn-type":[{"value":"1386-6346","type":"print"},{"value":"1872-034X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,10,31]]},"assertion":[{"value":"2018-07-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-09-18","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-10-31","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}