Urinary Estrogens in Male Patients with Liver Diseases 2. Relation to Liver Function Tests, Histrogical Findings, Clinical Courses and Symptomes.

Urines of seventy one male patients with liver diseases were analyzed for estrogens by modified Brown's method and Salokangas' micromethod, including fractionations of estrogens to estrone, estradiol and estriol. The following results were obtained. 1) No evident correlation between urinary excretion of estrogens and the results of routine liver function tests occured, but ratios of estriol/estrone + estradiol appeared to decrease on aggravation of liver functions. 2) Urinary excretions of estrogens and ratios of estriol/estrone + estradiol were not in distinct correlation with histological classification of liver diseases: acute hepatitis, chronic hepatitis and liver cirrhosis. 3) Urinary excretions of total estrogens and estradiol were distinctly increased to reduce ratios of estriol/estrone + estradiol in patients with deposition of bile pigment in liver cells and bile plugs in bile ducts as notable histological findings. On the other hand, urinary excretions of both estrogens and ratios of estriol/estrone + estradiol appeared to increase in patients with regeneration of liver cells, distortion of lobular architecture, and increase of connective tissue accompanied with its collagenation. 4) At acute icteric stages of most acute hepatitis urinary excretions of total estrogens were increased. On improvement of jaundice, estradiol decreased; estriol increased; and ratios of estriol/estrone + estradiol increased to their normal ranges in all four cases of acute hepatitis. On deterioration of four cases of liver cirrhosis, in two cases of which estrone and estriol in urines increased; and in another two cases decreased, and estradiol increased in three out of four cases. In all four cases of aggrevated liver cirrhosis, increases of total estrogens in urines paralleled with pronounced decreases of ratio of estriol/estrone + estradiol. 5) In patients with vascular spider, significant increases of estrone; estradiol; and total estrogens in urines, accompanied with significant decreases of ratios of estriol/estrone + estradiol, were observed. In patients with palmar erythema and gynecomastia, ratios of estriol/estrone + estradiol were decreased without alterations of etrogens excretion in urines