PDF(Pubmed)
Abstract：
Hepatocrinology explores the intricate relationship between liver function and the endocrine system. Chronic liver diseases such as liver cirrhosis can cause endocrine disorders due to toxin accumulation and protein synthesis disruption. Despite its importance, assessing endocrine issues in cirrhotic patients is frequently neglected. This article provides a comprehensive review of the epidemiology, pathophysiology, diagnosis, and treatment of endocrine disturbances in liver cirrhosis. The review was conducted using the PubMed/Medline, EMBASE, and Scielo databases, encompassing 172 articles. Liver cirrhosis is associated with endocrine disturbances, including diabetes, hypoglycemia, sarcopenia, thyroid dysfunction, hypogonadotropic hypogonadism, bone disease, adrenal insufficiency, growth hormone dysfunction, and secondary hyperaldosteronism. The optimal tools for diagnosing diabetes and detecting hypoglycemia are the oral glucose tolerance test and continuous glucose monitoring system, respectively. Sarcopenia can be assessed through imaging and functional tests, while other endocrine disorders are evaluated using hormonal assays and imaging studies. Treatment options include metformin, glucagon-like peptide-1 analogs, sodium-glucose co-transporter-2 inhibitors, and insulin, which are effective and safe for diabetes control. Established standards are followed for managing hypoglycemia, and hormone replacement therapy is often necessary for other endocrine dysfunctions. Liver transplantation can address some of these problems.
摘要：
肝细胞学探讨了肝功能与内分泌系统之间的复杂关系。慢性肝病如肝硬化可由于毒素积累和蛋白质合成中断而引起内分泌紊乱。尽管它很重要,评估肝硬化患者的内分泌问题经常被忽视。本文对流行病学进行了全面的回顾，病理生理学,诊断,和治疗肝硬化的内分泌紊乱。审查是使用PubMed/Medline进行的，EMBASE,和Scielo数据库，涵盖172篇文章。肝硬化与内分泌紊乱有关，包括糖尿病,低血糖,少肌症,甲状腺功能异常,低促性腺激素性性腺功能减退,骨病,肾上腺功能不全,生长激素功能障碍，和继发性醛固酮增多症。诊断糖尿病和检测低血糖的最佳工具是口服葡萄糖耐量试验和连续血糖监测系统，分别。肌肉减少症可以通过影像学和功能测试来评估，而其他内分泌疾病则使用激素测定和影像学研究进行评估。治疗方案包括二甲双胍,胰高血糖素样肽-1类似物，钠-葡萄糖协同转运蛋白-2抑制剂，和胰岛素，对糖尿病控制是有效和安全的。遵循既定的低血糖管理标准，激素替代疗法对于其他内分泌功能障碍通常是必要的。肝移植可以解决其中的一些问题。
