Liver at endocrine diseases. Overview

Abstract

Endocrine pathology can lead to hepatic dysfunction and, conversely, liver disease can cause endocrine dysfunction. In recent decades, there has been a rapid increase in the prevalence of metabolically associated steatohepatitis (MAS) and complications associated with the progression of this disease. Lipid metabolism in the liver and cholesterol synthesis depend on endocrine function and feedback mechanisms. Therefore, it is necessary to assess the impact of endocrine pathology in patients with MAOSD, and the treatment of these conditions should be included in the complex of traditional therapy. Liver function depends on adequate production of thyroid hormones, so the presence of liver pathology can also adversely affect thyroid hormone production due to inadequate conversion of thyroxine. The clinical consequences of hypothyroidism are diverse and can lead to increased transaminase levels, as well as changes in hepatic metabolism. Liver dysfunction can manifest as cholestasis. Elevated transaminase levels are seen in one-third of patients with hyperthyroidism. The likely primary cause is increased metabolic demands leading to hypoperfusion and mild hepatic ischemia. Glycogen storage hepatopathy is a rare complication of poorly controlled type 1 diabetes. It is characterized by hepatomegaly, elevated liver enzymes, and hepatic glycogen storage. This hepatopathy is often misdiagnosed as ACS. The correct diagnosis depends on the results of a PAS-positive liver biopsy. Estrogens can cause intrahepatic cholestasis in premenopausal women using oral contraceptives, in postmenopausal women taking hormone replacement therapy, and in men receiving estrogens for prostate cancer. Increased glucocorticoid levels in Cushing's syndrome have been implicated in the pathogenesis of insulin resistance, obesity, metabolic syndrome, and ACS. Patients with primary hyperaldosteronism are at increased risk for metabolic syndrome, impaired glucose metabolism, insulin resistance, and ACS. In patients with progressive liver damage, endocrine function should be monitored, especially in decompensated cirrhosis and acute liver failure.