Male Hypogonadism by Stephen J. Winters & Ilpo T. Huhtaniemi

Author:Stephen J. Winters & Ilpo T. Huhtaniemi
Language: eng
Format: epub
Publisher: Springer International Publishing, Cham

(2)Division of Endocrinology, Department of Medicine and Oncology, Diabetes, and Metabolism, School of Medicine, Johns Hopkins University, 1830 E. Monument St., Suite 328, Baltimore, MD 21287, USA

Samuel M. Kim

Email: [email protected]

Swaytha Yalamanchi

Email: [email protected]

Adrian S. Dobs (Corresponding author)

Email: [email protected]

Keywords

HypogonadismChronic liver diseaseCirrhosisLiverHemochromatosisAlcoholHepatitisNAFLD

Introduction

Chronic liver disease (CLD) and cirrhosis are common chronic medical illnesses, often from preventable causes, and remain the 12th leading cause of mortality in the United States [1]. New cases of CLD are diagnosed by persistently elevated liver enzymes, radiological evidence of cirrhosis, histopathology, or a clinical consequence of CLD such as variceal bleeding or ascites [1]. The progression of CLD from hepatocyte injury to cirrhosis is characterized by a diffuse, fibrosing, and generally irreversible condition that disrupts the normal architecture of the liver, particularly in the sinusoids [1]. The major etiologies of CLD include alcohol, hepatitis B or C infection, hemochromatosis, and nonalcoholic fatty liver disease (NAFLD) (Table 11.1). Data from National Health and Nutrition Examination Survey (NHANES) demonstrate that the prevalence of chronic liver disease ranged from 12 to 15% from 1988 to 2008 in the United States [2]. The overall prevalence rate of hepatitis B infection was approximately 0.3%, hepatitis C virus 1.6%, and alcoholic liver disease 2%. These prevalence rates have stayed relatively stable in the past two decades while that of NAFLD has increased from 5.5 to 11% in the last 20 years. NAFLD represented more than 75% of liver disease cases from 2005 to 2008. Hepatitis C virus (26%) remained the most common cause of cirrhosis with the highest number of liver transplants, while alcohol (20–25%) was a close second [2].Table 11.1Causes of chronic liver disease in the United States with reported prevalence and associated level of hypogonadism

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