Hypogonadism and liver fibrosis in HIV-infected patients.
Aspartate Aminotransferases
/ blood
Cohort Studies
Cross-Sectional Studies
HIV Infections
/ complications
Humans
Hypogonadism
/ epidemiology
Liver Cirrhosis
/ epidemiology
Luteinizing Hormone
/ blood
Male
Middle Aged
Prevalence
Retrospective Studies
Sex Hormone-Binding Globulin
/ analysis
Testosterone
/ blood
HIV
Hypogonadism
LH
Liver fibrosis
SHBG
Testosterone
Journal
Journal of endocrinological investigation
ISSN: 1720-8386
Titre abrégé: J Endocrinol Invest
Pays: Italy
ID NLM: 7806594
Informations de publication
Date de publication:
Sep 2021
Sep 2021
Historique:
received:
18
11
2020
accepted:
16
01
2021
pubmed:
31
1
2021
medline:
1
1
2022
entrez:
30
1
2021
Statut:
ppublish
Résumé
Hypogonadism is frequent in HIV-infected men and might impact on metabolic and sexual health. Low testosterone results from either primary testicular damage, secondary hypothalamic-pituitary dysfunction, or from liver-derived sex-hormone-binding-globulin (SHBG) elevation, with consequent reduction of free testosterone. The relationship between liver fibrosis and hypogonadism in HIV-infected men is unknown. Aim of our study was to determine the prevalence and type of hypogonadism in a cohort of HIV-infected men and its relationship with liver fibrosis. We performed a cross-sectional retrospective study including 107 HIV-infected men (median age 54 years) with hypogonadal symptoms. Based on total testosterone (TT), calculated free testosterone, and luteinizing hormone, five categories were identified: eugonadism, primary, secondary, normogonadotropic and compensated hypogonadism. Estimates of liver fibrosis were performed by aspartate aminotransferase (AST)-to-platelet ratio index (APRI) and Fibrosis-4 (FIB-4) scores. Hypogonadism was found in 32/107 patients (30.8%), with normogonadotropic (10/107, 9.3%) and compensated (17/107, 15.8%) being the most frequent forms. Patients with secondary/normogonadotropic hypogonadism had higher body mass index (BMI) (p < 0001). Patients with compensated hypogonadism had longer HIV infection duration (p = 0.031), higher APRI (p = 0.035) and FIB-4 scores (p = 0.008), and higher HCV co-infection. Univariate analysis showed a direct significant correlation between APRI and TT (p = 0.006) and SHBG (p = 0.002), and between FIB-4 and SHBG (p = 0.045). Multivariate analysis showed that SHBG was independently associated with both liver fibrosis scores. Overt and compensated hypogonadism are frequently observed among HIV-infected men. Whereas obesity is related to secondary hypogonadism, high SHBG levels, related to liver fibrosis degree and HCV co-infection, are responsible for compensated forms.
Identifiants
pubmed: 33515211
doi: 10.1007/s40618-021-01512-9
pii: 10.1007/s40618-021-01512-9
pmc: PMC8357638
doi:
Substances chimiques
Sex Hormone-Binding Globulin
0
Testosterone
3XMK78S47O
Luteinizing Hormone
9002-67-9
Aspartate Aminotransferases
EC 2.6.1.1
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
1971-1979Informations de copyright
© 2021. The Author(s).
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