{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T11:30:23Z","timestamp":1774438223864,"version":"3.50.1"},"reference-count":27,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,11,14]],"date-time":"2018-11-14T00:00:00Z","timestamp":1542153600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["DK111944"],"award-info":[{"award-number":["DK111944"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["UL1 TR000004"],"award-info":[{"award-number":["UL1 TR000004"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Viral Hepatitis"],"published-print":{"date-parts":[[2019,2]]},"abstract":"Summary<\/jats:title>Cirrhosis is associated with hormonal dysregulation, as evidenced by secondary amenorrhoea in reproductive\u2010aged women, and feminization of cirrhotic men. Whether hormone levels vary by severity of cirrhosis in women is not known. If identified, such changes may have important clinical relevance, particularly, as low sex hormone binding globulin (SHBG<\/jats:styled-content>) and follicle stimulating hormone (FSH<\/jats:styled-content>) are known to promote metabolic and cardiovascular disease in women. In a cohort of post\u2010menopausal women with chronic hepatitis C virus (HCV<\/jats:styled-content>) infection, we compared comprehensive sex hormone levels by presence of cirrhosis, as well as across Child\u2010Turcotte\u2010Pugh (CTP<\/jats:styled-content>) class. Results: There were n\u00a0=\u00a018 cirrhotic and n\u00a0=\u00a021 noncirrhotic women with a median age of 57\u00a0years (interquartile range [IQR<\/jats:styled-content>] 53\u201062). Compared to noncirrhotics, cirrhotic women had higher oestradiol (11.0 vs 6.0\u00a0pg\/mL, P<\/jats:italic>\u00a0=\u00a00.05) and oestrone levels (32.0 vs 8.0\u00a0ng\/mL, P<\/jats:italic>\u00a0<\u00a00.001), and lower sex hormone binding globulin (SHBG<\/jats:styled-content>) (69.2 vs 155.6\u00a0nmol\/L, P<\/jats:italic>\u00a0=\u00a00.001), and FSH<\/jats:styled-content> levels (4.9 vs 89.6 mIU<\/jats:styled-content>\/mL, P<\/jats:italic>\u00a0<\u00a00.001). Among cirrhotic women, there was a progressive decline in FSH<\/jats:styled-content> and SHBG<\/jats:styled-content> and concurrent rise in oestrone levels from CTP<\/jats:styled-content> class A to C (test of trend, P<\/jats:italic> values \u22640.02). Cirrhosis is associated with lower FSH<\/jats:styled-content> and SHBG<\/jats:styled-content> levels in cirrhotic compared to noncirrhotic women with HCV<\/jats:styled-content> infection. In cirrhotic women, these levels demonstrate steady decline by disease severity. Given known associations of low SHBG<\/jats:styled-content> and FSH<\/jats:styled-content> with cardio\u2010metabolic disease, the clinical implications of hormonal changes by cirrhosis severity in HCV<\/jats:styled-content>\u2010infected women warrants investigation.<\/jats:p>","DOI":"10.1111\/jvh.13027","type":"journal-article","created":{"date-parts":[[2018,10,19]],"date-time":"2018-10-19T19:00:30Z","timestamp":1539975630000},"page":"258-262","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Sex hormone levels by presence and severity of cirrhosis in women with chronic hepatitis C virus infection"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4233-1062","authenticated-orcid":false,"given":"Monika","family":"Sarkar","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology Department of Medicine University of California, San Francisco San Francisco California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer C.","family":"Lai","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Department of Medicine University of California, San Francisco San Francisco California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deirdre","family":"Sawinski","sequence":"additional","affiliation":[{"name":"Renal Electrolyte and Hypertension Division Department of Medicine University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toni E.","family":"Zeigler","sequence":"additional","affiliation":[{"name":"National Primate Research Center University of Wisconsin\u2010Madison Madison Wisconsin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcelle","family":"Cedars","sequence":"additional","affiliation":[{"name":"Division of Reproductive Endocrinology and Infertility Department of Obstetrics and Gynecology University of California, San Francisco San Francisco California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kimberly A.","family":"Forde","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Department of Medicine University of Pennsylvania Philadelphia Pennsylvania"},{"name":"Center for Clinical Epidemiology and Biostatistics Perelman School of Medicine University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,11,14]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2009.03.073"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(88)80039-4"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(05)80016-9"},{"key":"e_1_2_7_5_1","first-page":"588","article-title":"Endogenous sex hormones and their associations 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