从肝脏到激素:肝硬化的内分泌后果
Juan Eduardo Quiroz-Aldave1, Elman Rolando Gamarra-Osorio2, María Del Carmen Durand-Vásquez1
1Non-communicable Diseases, Endocrinology Research Line, Hospital de Apoyo Chepén, Chepén 13871, Peru.
World journal of gastroenterology
|April 5, 2024
概括
肝硬化经常导致内分泌系统疾病,如糖尿病和甲状腺功能障碍,影响患者的健康. 早期诊断和管理,包括激素替代和移植,对于改善结果至关重要.
科学领域:
- 肝硬化学 肝硬化学
- 内分泌学 在内分泌学.
- 胃肠病学 胃肠病学
背景情况:
- 慢性肝脏疾病,特别是肝硬化,破坏肝功能,导致毒素积累和蛋白质合成受损.
- 这些干扰可以导致显著的内分泌疾病,在临床实践中经常被忽视.
- 肝细胞学专注于肝脏在内分泌调节中的作用以及肝脏疾病对荷尔蒙平衡的影响.
研究的目的:
- 对肝硬化患者内分泌干扰的流行病学,病理生理学,诊断和治疗进行全面的审查.
- 突出指出,尽管内分泌评估具有临床意义,但在肝硬化患者中经常忽视内分泌评估.
- 巩固当前关于管理这些复杂的荷尔蒙失衡的知识.
主要方法:
- 使用PubMed/Medline,EMBASE和Scielo数据库进行了系统的文献审查.
- 综述中包括了172篇相关文章.
- 该综述综合了各种内分泌功能障碍,诊断工具和治疗策略的信息.
主要成果:
- 肝硬化与众多内分泌问题有关,包括糖尿病,低血糖症,肉症,甲状腺功能障碍,低激素性低激素症,骨疾病,上腺功能不充分,生长激素功能障碍和二次性高激素.
- 建议使用特定的诊断工具:用于糖尿病的口服葡萄糖耐受性测试,用于低血糖的持续葡萄糖监测,以及用于肉症的成像/功能测试.
- 激素检测和成像对于诊断其他内分泌系统疾病至关重要.
结论:
- 内分泌干扰是肝硬化的一个常见且显著的并发症,需要进行系统的评估.
- 存在有效的管理策略,包括药物治疗 (例如,甲胺,GLP-1类型,SGLT2抑制剂,糖尿病胰岛素),激素替代疗法和已建立的低血糖协议.
- 肝移植可以解决某些内分泌并发症,强调肝病的全身影响.
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