RELATION OF SERUM TOTAL TESTOSTERONE WITH SYMPTOMATOLOGY, COMPLICATIONS AND SEVERITY OF CHRONIC LIVER DISEASE IN MALE CIRRHOTICS

Abstract

Background: It has been seen that Testosterone (T) levels are generally low in men with advanced liver disease and progressively fall with increasing severity of liver disease. This may lead to the development of various clinical sequelae of advanced liver disease and adverse outcomes. Objectives: The study was done with an objective to assess serum testosterone in liver cirrhosis and to determine the relation of serum testosterone with symptomatology, complications and severity of liver cirrhosis in male patients. Methods: The observational study was carried out in G.G.S. Medical College and Hospital, Faridkot (Punjab, India). One hundred males of age 20-70 years with ultrasonographically proven cirrhosis of liver were included in the study. Demographic and clinical details of the patients were noted in the pre-designed proforma. Levels of serum total testosterone were measured in every patient. Laboratory investigations and Ultrasound of abdomen (with liver elastography) for cirrhosis liver was done. The severity of the disease was assessed by CTP and MELD score. Results: Signicant negative correlation of serum total testosterone was seen with MELD score, total bilirubin, ALP. Non signicant mild positive correlation was seen between serum total testosterone with serum albumin levels, blood platelet count, serum sodium levels and AFP. We found signicant association of low Testosterone levels with high CTP (p=0.007) and high MELD scores (p=0.042). No signicant association of complications was found with low testosterone. No association was seen with age, etiological factors or symptomatology except presence of jaundice. Conclusion: We identify low testosterone as a novel biomarker that is associated with increased severity of cirrhosis liver in men. This study provides a strong rationale to conduct adequately powered interventional trials to determine whether testosterone therapy can improve survival and other outcomes in this population.