To Study Adrenal Insufficiency and to Determine Relationship between Serum Albumin and Serum Cortisol Levels in Cirrhotic Patients

Abstract

Introduction: In patients with cirrhosis, albumin synthesis is decreased because of the loss of hepatic cell mass. Adrenal insufficiency (AI) has been demonstrated in patients with severe liver disease. The percentage of AI in cirrhotic patients varies among different studies and depends on different methods and criteria used to evaluate adrenal function. As both serum albumin and cortisol levels are low in cirrhotic patients we want to determine relationship between serum albumin and cortisol levels. Current research aimed to study adrenal insufficiency in patients of cirrhosis and to determine the relationship between serum albumin and serum cortisol levels. Material and Methods: Prospective study was done on 50 patients of cirrhosis who were admitted in medicine/ gastroenterology ward of DMC & H, Ludhiana. Depending on the levels of cortisol, patients were categorized into 3 groups. Clinically diagnosed patients of cirrhosis were included in our study whereas HIV/Immunodeficiency, Severe chronic heart disease, Chronic obstructive lung disease, Chronic hemodialysis, Severe sepsis, septic shock and patients on steroid therapy were excluded. Results: The data was analyzed using Microsoft excel and SPSS version 20.0 (IBM SPSS, Chicago, Illinois). Mean and standard deviation were computed for the variables. The comparison between groups were done by Chi square and ANOVA. AI was present in 14 (28%) patients of Cirrhosis. The difference between cortisol levels with respect to Albumin was found to be statistically significant (0.05). Conclusion: AI forms important part of spectrum of Cirrhosis and these patients should be evaluated for adrenal dysfunction.