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Mouse Model of Metabolic Dysfunction-Associated Steatotic Liver Disease with Fibrosis
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ASSESSMENT OF ADRENOCORTICAL DYSFUNCTION IN PATIENTS WITH STABLE LIVER CIRRHOSIS.

Ş Chiriac1, C Stanciu2, R Negru1

  • 1"Grigore T. Popa" University of Medicine and Pharmacy, Iaşi, Romania.

Acta Endocrinologica (Bucharest, Romania : 2005)
|June 1, 2019
PubMed
Summary

Relative adrenal insufficiency (RAI) is common in stable cirrhosis patients, affecting 21.3% in this study. The condition worsens with increased liver disease severity, highlighting its clinical relevance.

Keywords:
CortisolHepato-adrenal syndromeLiver cirrhosisRelative adrenal insufficiency

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Area of Science:

  • Endocrinology
  • Hepatology
  • Critical Care Medicine

Background:

  • Relative adrenal insufficiency (RAI) is frequently observed in critically ill patients and those with sepsis-induced hemodynamic instability.
  • Studies indicate RAI is also prevalent in patients with stable cirrhosis, even without sepsis.
  • This study aimed to prospectively evaluate the incidence of RAI in stable cirrhotic patients.

Purpose of the Study:

  • To determine the incidence of relative adrenal insufficiency (RAI) in patients with stable liver cirrhosis.
  • To investigate the correlation between RAI and the severity of liver disease in this patient population.

Main Methods:

  • Prospective study including 47 hemodynamically stable patients with liver cirrhosis without sepsis.
  • RAI was assessed using the low-dose short Synacthen test (LD-SST).
  • RAI was defined by basal cortisol < 3.6 µg/dL or peak cortisol ≤ 16 µg/dL post-stimulation.

Main Results:

  • RAI was diagnosed in 10 out of 47 (21.3%) patients with stable cirrhosis.
  • A negative correlation was found between peak cortisol levels and Child-Turcotte-Pugh (CTP) and Model for End-Stage Liver Disease (MELD) scores (r=-0.46 and r=-0.51, respectively; P<0.001).
  • The frequency of RAI increased with cirrhosis severity: 10% in CTP-A, 30% in CTP-B, and 60% in CTP-C.

Conclusions:

  • Relative adrenal insufficiency, diagnosed via LD-SST, is common in stable cirrhotic patients.
  • The presence and severity of RAI are linked to the severity of underlying liver disease.
  • Further research is necessary to elucidate the clinical significance of RAI in stable cirrhotic individuals.