Correlation of Serum Testosterone Section Levels in Men with Severity of Liver Dysfunction in Chronic Liver DiseaseAn Observational Study at a Tertiary Care Centre in Uttarakhand, India

Introduction: Chronic Liver Disease (CLD) and/or cirrhosis of liver represent different liver disorders of varying severity in which liver injury, inflammation, and fibrosis continue for more than six months. Various aetiologies including drugs toxins, alcohol abuse, infections, autoimmune disorders, genetic and metabolic diseases are implicated for CLD. Regardless, the aetiology of the CLD, the serum testosterone falls as the disease advances.

Aim: To study the serum testosterone level in male patients with CLD and its correlation with the severity of the disease.

Materials and Methods: A prospective observational study was conducted on patients reporting to Himalayan Hospital in OPD and IPD between June 2021 to May 2022. A total of 58 male patients of CLD were recruited. All patients were examined with clinical history, physical examination, laboratory blood and biochemical and radiological investigations, including total serum testosterone estimation. Testosterone value of <3 ng/mL was considered as low level. Child-Turcotte-Pugh (CTP) scores and Model for End-Stage Liver Disease-sodium (MELD-Na) scores were calculated to assess the severity of CLD.

Results: The mean age of the patients was 47.87±10.3 years. The majority of patients, 52/58 (89.65%), had low serum testosterone levels. As the severity of CLD increases, the testosterone falls progressively, and the finding was statistically significant (p-value=0.001). The mean testosterone levels (0.9±0.38) in patients with MELD-Na score of ≥20 was significantly (p-value=0.02) lower than the patients with MELD-Na score of <20. There was a strong negative correlation between low testosterone and CLD severity.

Conclusion: Overall, 89.65% of the patients had a low testosterone level. Serum testosterone level can be an independent marker for the severity of CLD in male patients.