[Androgen metabolism and Leydig-cell function in acute and chronic liver disease (author's transl)]

Diurnal variations of plasma testosterone and urinary excretion rates of testosterone-, androsterone-, aetiocholanolone-, and DHA-glucuronide, as well as DHA-sulphate were measured before and after selective Leydig-cell stimulation (with 3 X 5000 IU human gonadotrophin) in eight patients with alcoholic liver cirrhosis, ten with acute hepatitis and four with haemochromatosis. The circadian variation of plasma testosterone and the maximal testosterone concentration after human gonadotrophin stimulation were decreased in patients with cirrhosis and haemochromatosis, while in those with acute hepatitis the diurnal variations were evened out, whereas individual values were within the normal range. Urinary excretion of free testosterone and testosterone glucuronide was significantly reduced in those with cirrhosis and haemochromatosis before and after stimulation. The urinary pattern of C19 steroid metabolites was markedly changed in favour of the 5 alpha-steroids in acute heaptitis, cirrhosis, and haemochromatosis.