{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T15:16:00Z","timestamp":1789830960643,"version":"4.0.1"},"reference-count":50,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T00:00:00Z","timestamp":1760486400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Sarcopenia and frailty have been associated with hormonal dysregulation in non\u2010cirrhotic populations. The aim of the study was to evaluate hypothalamic\u2013pituitary\u2013adrenal and gonadal (HPA\u2010HPG) axes as well as growth hormone\/insulin\u2010like growth factor\u20101 (GH\/IGF\u20101) levels in patients with cirrhosis and their correlation with reduced muscle mass and frailty.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>One hundred twenty\u2010four patients with decompensated cirrhosis were prospectively included. Clinical and laboratory variables, including hormonal assessment, were evaluated. MELD\u2010Na and Child\u2010Turcotte\u2010Pugh scores were calculated. Muscle mass was estimated through mid\u2010arm muscle circumference and dual energy X\u2010ray absorptiometry. Short Physical Performance Battery (SPPB) and Liver Frailty Index (LFI) were also calculated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among the studied hormones, low DHEAS levels were the only independent factor associated with abnormal SPPB and LFI [Odds ratio (OR): 1.11,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.019 and OR: 0.97,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005 respectively]. Separate analysis on the basis of gender revealed that DHEAS was independently associated with abnormal SPPB and LFI only in men. \u03944 androstenedione [Hazard Ratio (HR): 0.64,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.038] and MELD\u2010Na score (HR: 1.108,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0057) were the only prognostic factors independently associated with mortality. MELD\u2010Na was significantly associated with the outcome in both male and female patients (HR: 1.052,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04 and HR: 1.22,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.009, respectively), whereas \u03944 androstenedione was significantly associated only in men (HR: 0.47,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our study is the first to evaluate HPA\u2010HPG and GH\/IGF\u20101 dysregulation in the same cohort of patients with decompensated cirrhosis. DHEAS was the only hormone correlated with frailty parameters and physical function, whereas low \u03944 androstenedione was associated with adverse outcomes in men.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/liv.70384","type":"journal-article","created":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T19:38:27Z","timestamp":1760557107000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Association of Hormonal Status With Sarcopenia, Frailty and Outcome in Patients With Decompensated Cirrhosis"],"prefix":"10.1111","volume":"45","author":[{"given":"Magdalini","family":"Adamantou","sequence":"first","affiliation":[{"name":"First Department of Internal Medicine Medical School of National and Kapodistrian University of Athens, General Hospital of Athens \u201cLaiko\u201d  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleni","family":"Pergantina","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine Medical School of National and Kapodistrian University of Athens, General Hospital of Athens \u201cLaiko\u201d  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-7254-4617","authenticated-orcid":false,"given":"Aikaterini","family":"Kamiliou","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine Medical School of National and Kapodistrian University of Athens, General Hospital of Athens \u201cLaiko\u201d  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolaos","family":"Rachiotis","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine Medical School of National and Kapodistrian University of Athens, General Hospital of Athens \u201cLaiko\u201d  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasileios","family":"Lekakis","sequence":"additional","affiliation":[{"name":"First Department of Gastroenterology Medical School of National and Kapodistrian University of Athens, General Hospital of Athens \u201cLaiko\u201d  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lampros","family":"Chrysavgis","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine Medical School of National and Kapodistrian University of Athens, General Hospital of Athens \u201cLaiko\u201d  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Papatheodoridis","sequence":"additional","affiliation":[{"name":"First Department of Gastroenterology Medical School of National and Kapodistrian University of Athens, General Hospital of Athens \u201cLaiko\u201d  Athens 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