Sex steroids and steroid binding proteins in primary biliary cirrhosis

In a longitudinal study on sex steroids and steroid binding proteins in primary biliary cirrhosis (PBC), 9 female patients were compared with 27 strictly age-matched healthy controls. In the patients we found elevated levels of androstenedione and, in advanced disease, of testosterone. Levels of total oestrone, dehydroepiandrosterone and dehydroepiandrosterone sulphate (DHAS) were not significantly different from controls, although numerically lower values were noted for the two later steroids in the PBC patients. The mean albumin level in the PBC patients was at the lower reference limit. A significant positive correlation between DHAS and albumin was found in the patients. The levels of sex hormone binding globulin (SHBG) were elevated in the patients and increased further with progressive disease as measured by N-demethylating capacity. The results suggest a close association, unrelated to sex hormone levels, between increased SHBG synthesis and progressive hepatocellular failure in PBC.